Normalization of the vagina by dilator treatment alone in Complete Androgen Insensitivity Syndrome and Mayer-Rokitansky-Kuster-Hauser Syndrome.
BACKGROUND
Various surgical and non-surgical treatment options are available for women with congenital vaginal agenesis. We report results of vaginal dilation therapy delivered by a multi-disciplinary team as first line treatment for vaginal agenesis.


METHODS
Twenty-six women were recruited into a prospective observational study: 18 had Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH) and 8 had Complete Androgen Insensitivity Syndrome (CAIS). All women underwent a vaginal dilation programme co-ordinated by a clinical nurse specialist with input from a clinical psychologist. Vaginal length was compared to a normal reference range, and psycho-sexual questionnaires were completed before and after therapy.


RESULTS
Twenty-one (81%) patients completed the programme. Seventeen of these 21 (81%) were sexually active without any reported difficulties, whereas 4 were on a maintenance regime. In those who completed the programme the mean vaginal length increased from 4.0 to 8.5 cm and 86% achieved a vaginal length within the normal range. Subjective appraisal of vaginal size recorded that the number of women who reported that their vaginal size was 'more or less normal' increased from 1 to 12 following treatment. Questionnaire scores for sexual satisfaction and sexual depression improved in the CAIS group but did not alter significantly in the MRKH group.


CONCLUSIONS
Non-surgical dilation delivered by a multi-disciplinary team is an effective alternative to vaginal surgery and usually normalizes vaginal length.
Ismail-Pratt
Ida S
IS
The Middlesex Centre at University College Hospital, Huntley Street, London WC1E 6HD, UK.
Bikoo
Maligaye
M
Liao
Lih-Mei
LM
Conway
Gerard S
GS
Creighton
Sarah M
SM
D000328:Adult; D013734:Androgen-Insensitivity Syndrome / Q000628:therapy*; D000728:Androgens / Q000378:metabolism*; D005260:Female; D005836:Genitalia, Female / Q000002:abnormalities*; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011446:Prospective Studies; D012725:Sexual Behavior; D019738:Surgically-Created Structures; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014621:Vagina / Q000002:abnormalities* / Q000033:anatomy & histology / Q000473:pathology*
D000728:Androgens