title: Sexual and functional results after creation of a neovagina in women with Mayer-Rokitansky-Küster-Hauser syndrome: a comparison of nonsurgical and surgical procedures.
abstract: OBJECTIVE
  To compare nonsurgical and surgical procedures for creation of a neovagina in women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome in terms of sexual satisfaction.
  
  
  METHODS
  We report a cross-sectional study of 91 women with MRKH syndrome undergoing a neovagina creation procedure. They were members of the French National Association of Women with MRKH syndrome. We analyzed all answers to a questionnaire mailed to each woman. The questionnaire solicited short answers concerning the diagnosis and the neovagina procedure, and included the standardized FSFI (Female Sexual Function Index) questionnaire. All analyses were performed using the chi-squared test and Student's t-test. A p-value of <0.05 was considered statistically significant.
  
  
  RESULTS
  Forty women answered the questionnaire. Twenty had been treated by Frank's method (non-surgical group) and 20 had undergone a surgical procedure, sigmoid vaginoplasty (12 cases) or Davidov's technique (8 cases) (surgical group). The mean time after neovagina creation was 7 years (range 1-44 years). The population characteristics did not differ significantly between the nonsurgical and surgical groups. The total FSFI score indicated good and similar functional results in the two groups (25.3±7.5 versus 25.3±8.0).
  
  
  CONCLUSIONS
  Functional sexual outcomes after nonsurgical and surgical methods were similar. Therefore, the Frank's method should be proposed as first line therapy because it is less invasive than surgical procedures. In the case of failure of this technique or of refusal by the patient, surgical reconstruction may then be offered.
authors.affiliation: CHU Rennes, Pôle d'Obstétrique Gynécologie et Médecine de la Reproduction, Rennes, France. karine.morcel@chu-rennes.fr
authors.forename: Karine
authors.initials: K
authors.lastname: Morcel
authors.forename: Vincent
authors.initials: V
authors.lastname: Lavoué
authors.forename: Frédérique
authors.initials: F
authors.lastname: Jaffre
authors.forename: Bernard-Jean
authors.initials: BJ
authors.lastname: Paniel
authors.forename: Roman
authors.initials: R
authors.lastname: Rouzier
mesh_terms: D058489:46, XX Disorders of Sex Development / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000013:Congenital Abnormalities / Q000601:surgery*; D003430:Cross-Sectional Studies; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D009095:Mullerian Ducts / Q000002:abnormalities* / Q000601:surgery; D019529:Sexuality / Q000502:physiology*; D019738:Surgically-Created Structures / Q000502:physiology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014621:Vagina / Q000502:physiology / Q000601:surgery*; D055815:Young Adult
keywords: Frank's method; Mayer–Rokitansky–Küster–Hauser syndrome; Neovagina; Sexual function; Vaginoplasty