Abstract
Mayer–Rokitansy–Küster–Hauser syndrome is the most common cause of congenital vaginal agenesis, occurring in one in every 1500–4000 female births, and to a lesser extent complete androgen insensitivity syndrome can also be diagnosed. Diagnosis is generally shocking for young patients and their relatives, and in certain cases psychological help is needed even for choosing the appropriate time to start therapy. Whichever strategy is planned, the patient’s collaboration is strongly necessary. Several therapeutic approaches have been proposed and each investigator generally claims that his/her own method is the most successful, but the small number of cases does not permit any definitive conclusions. In cases of failure of self-dilatation, which should be the first approach, a surgical approach is needed, and is chosen according to the surgeon’s experience and patient’s preference. In this article, the various nonoperative and operative techniques are reported, considering the advantages and disadvantages for each method in terms of sexual satisfaction and risk of complications. Despite the various options, self-dilatation remains the first-line therapy, in view of the reliable results that can be obtained, and it should also be noted that this method is devoid of any risk of major complications. Moreover, the use of the mold is often needed in almost all of the surgical techniques, so that previous training makes the young patients more confident with the use of dilators.
Financial & competing interests disclosure
The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.