Outcomes of surgical treatments for acquired gynatresia in a tertiary institution in Ibadan, Nigeria

Abstract

A 16-year review of causes, clinical presentation and management outcomes of Acquired gynatresia (AG) at University College Hospital, Ibadan, Nigeria. Information was obtained using a proforma and data analysed using SPSS version 20.0. The mean age of the 31 women with AG was 35.6 ± 6.2 years. The majority (90.3%) were married and had a tertiary level of education. The mean parity was 0.74 ± 1.1 and 54.8% were nulliparous while 29.0% were primiparous women. The commonest cause of AG was the insertion of caustic substances into the vagina and this was mainly for the treatment of uterine fibroid (68.2%) and infertility (54.5%). Over three-quarters presented with dyspareunia while 54.8% had infertility. A majority (87.1%) had one-stage surgery with dissection/excision of fibrotic tissue being the commonest (45.2%) and sigmoid vaginoplasty the least performed. Postoperative complications were seen in 29.0% of cases. Acquired gynatresia remains a condition of public health interest despite an increase in female education and relatively improved health care in Nigeria.

Impact statement

• What is already known on this subject? Acquired gynatresia (AG) could be of chemical and non-chemical origin and result from certain cultural beliefs and practices.

• What do the results of this study add? Irrespective of the women’s level of education, there is inadequate awareness of the implications of inserting caustic materials into the vagina. However, there is a high success rate of treatment of AG.

• What the implications are of these findings for clinical practice and/or further research? There is a need to increase health education and awareness of the populace on the causes of AG and its associated complications.

Keywords:

• Acquired gynatresia
• caustic substance
• dyspareunia
• surgical outcome
• Ibadan

Authors’ contributions

OO Bello and OA Ojengbede: Project development

OO Lawal and OO Bello: Data collection and analysis

OO Bello, IO Morhason‐Bello, OO Lawal, RA Abdus-salam, AO Iyun, and OA Ojengbede: Manuscript writing and editing.

Disclosure statement

No potential conflict of interest was reported by the author(s).