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An alternative approach to vaginal dilation in patients with Meyer-Rokitanski-Küster-Hauser syndrome: two case reports.

Abstract
Vaginal dilation, currently considered as the first-line therapy for vaginal aplasia in patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, is a safe and effective treatment that aims to create a functional neovagina. However, rigid vaginal dilators classically described in the literature usually cause physical discomfort and side effects that can lead to vaginal necrosis. Here, we present two cases of MRKH syndrome patients with vaginal agenesis whose main complaint was the inability to have sexual intercourse with their partners. Considering unavailability of acrylic dilators and previous studies reporting good responses with the use of silicone dilators in women with post-radiotherapy vaginal stenosis, the medical team and patients opted for creation of a neovagina through the daily use of silicone vaginal dilators. Patient 1 developed an 8-cm vagina after 6 months of treatment and had a satisfactory sex life with her partner. Patient 2 developed a 7-cm vagina and reported significant symptom improvement. None of the patients developed side effects after the treatment. The use of inexpensive and easily accessible silicone vaginal dilators may be an effective and noninvasive alternative with few side effects for women with vaginal agenesis, particularly in the developing countries.
AuthorsKátia Crys Moura Ogliari, Salete da Silva Rios, Ana Carolina Rios Chen, Juliana Rios Chen, Ceres Nunes Resende, Edward Araujo Júnior
JournalGynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology (Gynecol Endocrinol) Vol. 36 Issue 8 Pg. 746-748 (Aug 2020) ISSN: 1473-0766 [Electronic] England
PMID31994956 (Publication Type: Case Reports, Journal Article)
Topics
  • 46, XX Disorders of Sex Development (pathology, therapy)
  • Adult
  • Coitus (physiology)
  • Congenital Abnormalities (pathology, therapy)
  • Conservative Treatment
  • Dilatation (instrumentation, methods)
  • Female
  • Gynecologic Surgical Procedures (adverse effects, instrumentation, methods)
  • Humans
  • Mullerian Ducts (abnormalities, pathology)
  • Treatment Outcome
  • Vagina (abnormalities, pathology)
  • Young Adult

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