Sexuality after sigmoid vaginoplasty in patients with Mayer-Rokitansky-Küster-Hauser syndrome

Fertil Steril. 2012 Mar;97(3):691-6. doi: 10.1016/j.fertnstert.2011.12.015. Epub 2012 Jan 14.

Abstract

Objective: To investigate the functional and sexual outcome of sigmoid vaginoplasty in patients with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome.

Design: Prospective study.

Setting: University hospital.

Patient(s): Fifty-nine consecutive patients with MRKH syndrome.

Intervention(s): Forty-eight patients underwent sigmoid vaginoplasty, and 11 were treated using the Frank method of dilatation.

Main outcome measure(s): Functional results and sexuality were evaluated with the use of two standardized questionnaires: the Female Sexual Function Index (FSFI) and the revised Female Sexual Distress Scale (FSDS-R). Questions were added to analyze depression, body image perception, and desire of motherhood.

Result(s): Out of the 68% of patients who answered the questionnaire, 73% had regular sexual intercourse. The mean total FSFI score was 28 ± 3.1 in the operated group and 30 ± 5.3 in the group treated with the Frank method. Their mean FSDS-R scores were 21 ± 12.1 and 18 ± 13.8, respectively.

Conclusion(s): Sigmoid vaginoplasty is an effective technique providing a nearly normal sexual function to patients with vaginal aplasia. Despite this, psychologic distress related to sexuality persists in most patients, demonstrating the need for a multidisciplinary support.

MeSH terms

  • 46, XX Disorders of Sex Development / physiopathology
  • 46, XX Disorders of Sex Development / psychology
  • 46, XX Disorders of Sex Development / surgery*
  • Abnormalities, Multiple / physiopathology
  • Abnormalities, Multiple / psychology
  • Abnormalities, Multiple / surgery*
  • Adoption / psychology
  • Body Image
  • Chi-Square Distribution
  • Congenital Abnormalities
  • Depression / etiology
  • Female
  • France
  • Gynecologic Surgical Procedures* / adverse effects
  • Hospitals, University
  • Humans
  • Insemination, Artificial, Heterologous / psychology
  • Kidney / abnormalities
  • Mullerian Ducts / abnormalities
  • Patient Satisfaction
  • Perception
  • Recovery of Function
  • Sexuality*
  • Somites / abnormalities
  • Spine / abnormalities
  • Surgically-Created Structures* / adverse effects
  • Surrogate Mothers / psychology
  • Surveys and Questionnaires
  • Treatment Outcome
  • Uterus / abnormalities
  • Uterus / physiopathology
  • Uterus / surgery
  • Vagina / abnormalities
  • Vagina / physiopathology
  • Vagina / surgery*
  • Young Adult

Supplementary concepts

  • Mullerian aplasia