American Journal of Obstetrics and Gynecology
ResearchGynecologyVaginal dilation treatment in women with vaginal hypoplasia: a prospective one-year follow-up study
Section snippets
Study design, outcome variables, and population
This was a prospective, longitudinal, single-center study of all women with vaginal hypoplasia and without a previous history of vaginal surgery, who were prescribed vaginal dilation treatment, between March 2010 and April 2013. Participants followed the treatment protocol outlined in Figure 2. The outpatient program was designed based on previous experiences and careful exploration of the literature, especially motivational and behavioral psychology.10, 15
At baseline (T0), at the stop of
Results
Of the 18 women approached, 16 agreed to participate (Figure 3). Two women were reluctant to discuss this sensitive issue, but both did start with the dilation program. The characteristics of the participants are displayed in Table 2.
Maintenance Dilation
In women who completed the program, only 2 women (numbers 1 and 7) continued to dilate during the first 6 months after the stop (once a week), especially before having sexual intercourse. Only 1 woman (number 7) dilated at the time of follow-up (approximately 4 times a month for 10 minutes) because she felt that she lost vaginal depth when not being sexually active and because she wanted to gain additional depth. She had a significantly longer vaginal length at follow-up (11 cm vs 6.5 cm [6.5-7
Comment
The present study demonstrates that in the majority of women with vaginal agenesis (77%, 10 of 13), vaginal dilation therapy, following a strict protocol and with continuous psychophysiological support, can effectively create a vagina within normal ranges (6.5–13 cm)21, 22 in a period of approximately 6 months, which corroborates previous study findings.1, 4, 10, 23, 24 With higher dilation frequency, the total duration of therapy decreased and vaginal end length increased, irrespective of
Acknowledgments
We thank the women who took part in the study and all members of the multidisciplinary disorders of sex development teams at Ghent University Hospital, Belgium, and Erasmus Medical Centre Rotterdam, The Netherlands for their continuing encouragement of this research.
References (44)
- et al.
Management of vaginal agenesis
J Pediatr Adolesc Gynecol
(2012) - et al.
An observational study of women with mullerian agenesis and their need for vaginal dilator therapy
Fertil Steril
(2011) - et al.
Vaginal substitution: attempts to create the ideal replacement
J Urol
(2007) - et al.
Objective cosmetic and anatomical outcomes at adolescence of feminising surgery for ambiguous genitalia done in childhood
Lancet
(2001) The formation of an artificial vagina without operation
Am J Obstet Gynecol
(1938)- et al.
Management strategies for Mayer-Rokitansky-Kuster-Hauser related vaginal agenesis: a cost-effectiveness analysis
J Urol
(2010) - et al.
Sexual function in women with complete androgen insensitivity syndrome
Fertil Steril
(2003) - et al.
From “sex toy” to intrusive imposition: a qualitative examination of women's experiences with vaginal dilator use following treatment for gynecological cancer
J Sex Med
(2012) - et al.
Emotional and sexual wellness and quality of life in women with Rokitansky syndrome
Am J Obstet Gynecol
(2011) - et al.
To adjust or not adjust: nonparametric effect sizes, confidence intervals, and real-world meaning
Psychol Sport Exerc
(2013)
The bicycle seat stool in the treatment of vaginal agenesis and stenosis: a preliminary report
Am J Obstet Gynecol
Management of congenital absence of the vagina
Am J Obstet Gynecol
The management of vaginal agenesis: report of 104 cases
Fertil Steril
Congenital absence of the vagina—results of conservative treatment
Eur J Obstet Gynecol Reprod Biol
Psychological distress in women with uterovaginal agenesis (Mayer-Rokitansky-Kuster-Hauser syndrome, MRKH)
Psychosomatics
Validation of the Female Sexual Distress Scale-revised for assessing distress in women with hypoactive sexual desire disorder
J Sex Med
Should progressive perineal dilation be considered first line therapy for vaginal agenesis?
J Urol
Androgen receptor defects: historical, clinical, and molecular perspectives
Endocr Rev
Management of vaginal hypoplasia in disorders of sexual development: surgical and non-surgical options
Sex Dev
Surgical approaches to treating vaginal agenesis
BJOG
Normalization of the vagina by dilator treatment alone in complete androgen insensitivity syndrome and Mayer-Rokitansky-Kuster-Hauser syndrome
Hum Reprod
A nonsurgical approach to the treatment of vaginal agenesis
Cited by (0)
This study was supported by a research grant from the Flanders Research Foundation (FWO Vlaanderen).
The authors report no conflict of interest.
Cite this article as: Callens N, Weyers S, Monstrey S, et al. Vaginal dilation treatment in women with vaginal hypoplasia: a prospective one-year follow-up study. Am J Obstet Gynecol 2014;211:228.e1-12.