Success following vaginal creation for Müllerian agenesis.
Eighty-eight women with Müllerian agenesis underwent vaginal dilatation (n = 21) and/or vaginal creation using a modified McIndoe technique (n = 79). Patient and family counseling was considered an essential component of the therapy regimen. An initial trial of vaginal dilatation was successful in 9 of 21 patients (43%). Failure was associated with a prior vaginal exploration in eight women. All of the 79 women experienced satisfactory sexual activity and were satisfied with vaginal depth following vaginal creation using a split thickness graft technique. However, anatomic success, as judged by the surgeon, was noted in 72 patients (91%). Our experience suggests an initial trial of vaginal dilatation coupled with careful instruction and family counseling is appropriate in the motivated patient. However, vaginoplasty using a split thickness graft technique is highly successful and should be offered to those patients unwilling or unable to obtain an adequate neovagina with dilatation.
D000015:Abnormalities, Multiple / Q000601:surgery; D000293:Adolescent; D000328:Adult; D003376:Counseling; D004106:Dilatation; D005260:Female; D006801:Humans; D009095:Mullerian Ducts; D019736:Prostheses and Implants; D012723:Sex; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery