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.

摘要

阴道顶压延长法目前被认为是治疗Mayer–Rokitansky–Küster–Hauser(MRKH)综合征患者阴道发育不全的一线疗法, 以塑造功能性新阴道为目的, 安全有效。然而, 文献中描述的经典刚性阴道顶压模具通常会引起身体不适和副作用, 可能导致阴道坏死。在这里, 我们报道了两例阴道发育不全的MRKH综合征患者, 他们的主诉是不能与性伴侣进行性生活。考虑到聚丙烯顶压模具不可用, 以及之前的研究报道, 在放射治疗后阴道狭窄的女性中使用硅胶顶压模具反应良好, 医疗组和患者选择通过每天使用硅胶阴道顶压模具来形成新阴道。患者1经过6个月的治疗后, 阴道长达8厘米, 并与她的伴侣有了令人满意的性生活。患者2形成7厘米长的阴道, 并报告症状明显改善。治疗后无一例患者出现副作用。对于阴道发育不全的患者, 特别是在发展中国家, 使用廉价和容易获得的硅胶阴道顶压模具可能是一种有效和非侵入性的替代方案, 并且副作用很小。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Mayer–Rokitansky– Küster–Hauser syndrome
• vaginal aplasia
• neovagina
• vaginal dilator
• new approach

Disclosure statement

The authors declare that they have no conflicts of interest regarding the publication of this paper.

Consent form

Consent form was obtained from the patients for publication of this article and any accompanying images.

Care guideline

The authors followed the CARE guidelines for preparing this case report.