title: Sexual and Psychosocial Functioning in Women with MRKHS after Neovaginoplasty According to Wharton-Sheares-George: A Case Control Study.
abstract: BACKGROUND
  Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) has a major impact on a woman's psychological and sexual well-being. In most of the studies that addressed treatment techniques, postoperative sexual function was reported to be satisfactory; however, comparatively few studies have additionally provided an accurate analysis of psychosocial functions in MRKHS patients following different kinds of neovaginal treatment. This study is to evaluate sexual and psychosocial functioning after creation of a neovagina according to Wharton-Sheares-George in women with MRKHS.
  
  
  METHODS
  We performed a case-control-study using multiple measures to assess sexual and psychosocial functioning. Ten MRKHS patients and 20 controls of a University hospital and tertiary center for pediatric and adolescent gynecology were assessed. The follow-up assessment comprised 6 standardized questionnaires (Female Sexuality Function Index, FSFI; Patient Health Questionnaire, PHQ; Brief Symptom Inventory, BSI; World Health Organization Quality of Life Assessment, WHOQoL-BREF; Parental Bonding Instrument, PBI; and a German questionnaire on body image). The main outcome measures were sexual function, psychological status, quality of life, body image, and parental bonding styles.
  
  
  RESULTS
  Sexual function, psychological status (including depressive and somatic symptoms), quality of life, and own-body experience were at least as good in operated MRKHS patients as in controls. In some measures (FSFI, PHQ-15, psychological domain of the WHOQoL-BREF, and BSI Positive Symptom Total), patients scored significantly better than controls. The results of the PBI indicated a close and sustainable mother-daughter-relationship in MRKHS patients.
  
  
  CONCLUSIONS
  We found no evidence for an impairment of sexual or psychosocial functioning in patients after neovaginoplasty according to Wharton-Sheares-George. MRKHS may not necessarily compromise sexual and psychological well-being, provided that the syndrome is properly managed by a multidisciplinary team of health professionals.
authors.affiliation: Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria.
authors.forename: Katharina
authors.initials: K
authors.lastname: Leithner
authors.affiliation: Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria.
authors.forename: Andrea
authors.initials: A
authors.lastname: Naderer
authors.affiliation: Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria.
authors.forename: Dorothee
authors.initials: D
authors.lastname: Hartung
authors.affiliation: Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria.
authors.forename: Clara
authors.initials: C
authors.lastname: Abrahamowicz
authors.affiliation: Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria.
authors.forename: Johanna
authors.initials: J
authors.lastname: Alexopoulos
authors.affiliation: Department of Obstetrics and Gynaecology, Divison of Gynaecology and Gynaecological Oncology, Medical University Vienna, Vienna, Austria.
authors.forename: Katharina
authors.initials: K
authors.lastname: Walch
authors.affiliation: Department of Obstetrics and Gynaecology, Divison of Gynaecology and Gynaecological Oncology, Medical University Vienna, Vienna, Austria.
authors.forename: René
authors.initials: R
authors.lastname: Wenzl
authors.affiliation: Department of Neurology, Medical University Vienna, Vienna, Austria.
authors.forename: Eva
authors.initials: E
authors.lastname: Hilger
mesh_terms: D058489:46, XX Disorders of Sex Development / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery*; D016022:Case-Control Studies; D000013:Congenital Abnormalities / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery*; D003710:Demography; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D009095:Mullerian Ducts / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery; D010290:Parents; D012725:Sexual Behavior / Q000523:psychology*; D014621:Vagina / Q000503:physiopathology* / Q000601:surgery*; D055815:Young Adult