Creation and maintenance of neo-vagina with the use of vaginal dilators as first line treatment: Results from a quaternary paediatric and adolescent gynaecology service in Australia.
neo-vagina
vaginal agenesis
vaginal dilator
Journal
The Australian & New Zealand journal of obstetrics & gynaecology
ISSN: 1479-828X
Titre abrégé: Aust N Z J Obstet Gynaecol
Pays: Australia
ID NLM: 0001027
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
pubmed:
19
2
2022
medline:
23
6
2022
entrez:
18
2
2022
Statut:
ppublish
Résumé
Vaginal agenesis is an uncommon condition with an estimated incidence of 1/5000 live female births. There are surgical and non-surgical treatment options for neo-vagina creation. Vaginal dilatation has been used to treat vaginal agenesis for over 80 years, but outcome data to date have had poor definitions for 'success'. The optimal method for neo-vagina creation varies with vaginal dilator therapy being the most successful first line therapy in women with Mayer-Rokistansky-Kuster-Hauser syndrome, with little literature to guide best practice in women with more complex congenital conditions. There is a paucity of data from Australian and New Zealand paediatric and adolescent gynaecology services on management of women requiring a functional vagina, for any underlying aetiology. To determine if creation and maintenance of a functional neo-vagina for vaginal agenesis with non-surgical management (via vaginal dilators) should be the first line treatment. Retrospective observational study between January 2005 and June 2015. Of the 23 women, 21 (91.3%) achieved a successful vaginal length defined as achieving vaginal length >6 cm and maximum width using the largest dilator if not sexually active, or ability to have sexual intercourse without discomfort. Vaginal dilator therapy remains an effective first line treatment for neo-vagina creation and maintenance and can be achieved in an outpatient setting with appropriate support.
Sections du résumé
BACKGROUND
Vaginal agenesis is an uncommon condition with an estimated incidence of 1/5000 live female births. There are surgical and non-surgical treatment options for neo-vagina creation. Vaginal dilatation has been used to treat vaginal agenesis for over 80 years, but outcome data to date have had poor definitions for 'success'. The optimal method for neo-vagina creation varies with vaginal dilator therapy being the most successful first line therapy in women with Mayer-Rokistansky-Kuster-Hauser syndrome, with little literature to guide best practice in women with more complex congenital conditions. There is a paucity of data from Australian and New Zealand paediatric and adolescent gynaecology services on management of women requiring a functional vagina, for any underlying aetiology.
AIMS
To determine if creation and maintenance of a functional neo-vagina for vaginal agenesis with non-surgical management (via vaginal dilators) should be the first line treatment.
MATERIALS AND METHODS
Retrospective observational study between January 2005 and June 2015.
RESULTS
Of the 23 women, 21 (91.3%) achieved a successful vaginal length defined as achieving vaginal length >6 cm and maximum width using the largest dilator if not sexually active, or ability to have sexual intercourse without discomfort.
CONCLUSION
Vaginal dilator therapy remains an effective first line treatment for neo-vagina creation and maintenance and can be achieved in an outpatient setting with appropriate support.
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
439-444Informations de copyright
© 2022 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
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