International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics | 2021
Treatment for vaginal agenesis: A prospective and comparative study between vaginal dilation and surgical neovaginoplasty.
Abstract
OBJECTIVE\nThe purpose of this study was to compare, in terms of anatomical, functional and sexual aspects, two types of treatment for women with vaginal agenesis: progressive dilation or surgical neovaginoplasty.\n\n\nMETHODS\nThe present study included 20 women with vaginal agenesis. Nine were underwent dilation treatment using the Frank method and 11 surgical treatment using the modified Abbé-McIndoe technique with oxidized cellulose. Patients were evaluated 3-6 months after treatment for a follow-up including, medical history, physical examination, general satisfaction, clinical aspect of the vagina, Female Sexual Function Index (FSFI) and 3D pelvic floor ultrasound (US).\n\n\nRESULTS\nComparison between the groups (vaginal dilation and surgical neovaginoplasty) showed efficacy in neovagina formation after both treatments, with a statistically significant difference between the pre and post treatment periods (P value Pre X Post Dilation group: < 0.0001* and P value Pre X Post Surgical group < 0.0001*). There were no statistical difference in TVL measurements (P value Post Dilation x Post Surgical: 0,09); FSFI scores (P=0,72) after both treatments.\n\n\nCONCLUSION\nBoth treatments had satisfactory efficacy and positive outcomes for patients with vaginal agenesis concerning anatomical, functional, and sexual aspects, with minimum complications in the surgical group. Dilation treatment can remain the first-line therapy.