Sexual functional outcomes of vaginal dilation therapy for MRKH syndrome: a prospective study
10.3760/cma.j.cn112141-20240318-00159
- VernacularTitle:MRKH综合征患者顶压法人工阴道成形术的性功能评价
- Author:
Jiali DUAN
1
;
Na CHEN
;
Qianqian GAO
;
Roujie HUANG
;
Shuang SONG
;
Jia KANG
;
Xia LIU
;
Xiangyu GU
;
Shan DENG
;
Lan ZHU
Author Information
1. 中国医学科学院北京协和医学院北京协和医院妇产科 国家妇产疾病临床医学研究中心 疑难重症及罕见病国家重点实验室，北京 100730
- Keywords:
46,XX disorders of sex development;
Congenital abnormalities;
Uterus;
Vagina;
Reconstructive surgical procedures;
Prospective studies
- From:
Chinese Journal of Obstetrics and Gynecology
2024;59(7):540-547
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To report the sexual functional outcomes of vaginal dilation therapy in Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome patients.Methods:From March 2020 to February 2023, 97 MRKH syndrome patients performed vaginal dilation therapy with guidance from Peking Union Medical College Hospital, and 45 of them engaged in penetrative intercourse and were included in this prospective cohort study. The Chinese version of female sexual function index (FSFI) was used to assess sexual function. Functional success was defined as FSFI>23.45. Forty age-matched healthy women were selected as controls. Kaplan-Meier survival analysis was used to calculate the median time to success. Pearson correlation analysis was used to explore the relationship between neovagina length and sexual function. Complications were collected using follow-up questionnaires.Results:The functional success rate of vaginal dilation therapy was 89% (40/45) with a median time to success of 4.3 months (95% CI: 3.0-6.1 months). Compared to controls, MRKH syndrome patients had significantly lower scores in the orgasm domain (4.72±1.01 vs 4.09±1.20; P=0.013) and pain domain (5.03±0.96 vs 4.26±0.83; P<0.001). However, there were no significant differences in the FSFI total score (26.77±2.70 vs 26.70±2.33; P=0.912), arousal domain (4.43±0.77 vs 4.56±0.63; P=0.422) and satisfaction domain (4.88±0.98 vs 4.65±0.86; P=0.269) between MRKH syndrome patients and controls. MRKH syndrome patients had significantly higher scores in the desire domain (3.33±0.85 vs 3.95±0.73; P<0.001) and lubrication domain (4.37±0.56 vs 5.20±0.67; P<0.001). The prevalence of sexual dysfunction in MRKH patients was non-inferior to controls: low desire [3% (1/40) vs 23% (9/40); P=0.007], arousal disorder [3% (1/40) vs 3% (1/40); P>0.999], lubrication disorder [5% (2/40) vs 25% (10/40); P=0.012], orgasm disorder [40% (16/40) vs 20% (8/40); P=0.051], sexual pain [30% (12/40) vs 15% (6/40); P=0.108]. Conclusions:MRKH syndrome patients undergoing non-invasive vaginal dilation therapy could achieve satisfactory sexual life. Given its high functional success rate and slight complication, vaginal dilation therapy should be recommended as the first-line option, reducing the need for unnecessary surgeries.
