title: An observational study of women with müllerian agenesis and their need for vaginal dilator therapy.
abstract: OBJECTIVE
  To assess vaginal development, sexual activity, and the efficacy of vaginal dilator therapy in women with vaginal agenesis (Mayer-Rokitansky-Kuster-Hauser syndrome).
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  Tertiary referral university teaching hospital clinic for disorders of sexual development and differentiation (DSDD).
  
  
  METHODS
  Eighty cases of Rokitansky syndrome.
  
  
  METHODS
  None.
  
  
  METHODS
  Sexual activity and vaginal dimensions.
  
  
  RESULTS
  The retrospective case review examined vaginal dimensions and sexual activity at presentation with further evaluation at completion of vaginal dilator therapy. Eleven of 80 patients had undergone surgery in the past; six of these 80 women had received dilator training elsewhere, and four were sexually active. Sixty-three of 80 patients had not undergone any previous treatment. Seventeen were having satisfactory sexual intercourse, 16 were having unsatisfactory sexual intercourse, and 26 had never been sexually active; for four women, no information had been recorded. A total of 32 patients underwent vaginal dilator treatment, and 25 completed the therapy. Their vaginal length increased from 3.2 cm (range: 0 to 7 cm) to 6.1 cm (range: 3 to 9 cm).
  
  
  CONCLUSIONS
  Diagnosis and management of müllerian agenesis may be achieved without the need for surgery in the majority of cases. Dilator treatment for vaginal agenesis should be offered as first-line treatment, coordinated by a specialist nurse with input from a psychologist.
authors.affiliation: Leeds Centre for Reproductive Medicine, Leeds Teaching Hospitals, Seacroft Hospital, Leeds, United Kingdom.
authors.forename: Fiona
authors.initials: F
authors.lastname: Bach
authors.forename: Julie M
authors.initials: JM
authors.lastname: Glanville
authors.forename: Adam H
authors.initials: AH
authors.lastname: Balen
mesh_terms: D058489:46, XX Disorders of Sex Development / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D000015:Abnormalities, Multiple / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D003075:Coitus; D000013:Congenital Abnormalities; D004106:Dilatation / Q000295:instrumentation; D004739:England; D004867:Equipment Design; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities; D008875:Middle Aged; D009095:Mullerian Ducts / Q000002:abnormalities*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012725:Sexual Behavior; D019170:Somites / Q000002:abnormalities; D013131:Spine / Q000002:abnormalities; D013997:Time Factors; D016896:Treatment Outcome; D014599:Uterus / Q000002:abnormalities / Q000503:physiopathology; D014621:Vagina / Q000002:abnormalities / Q000503:physiopathology; D055815:Young Adult