Ismail-Pratt Ida S, Bikoo Maligaye, Liao Lih-Mei, Conway Gerard S, Creighton Sarah M
The Middlesex Centre at University College Hospital, Huntley Street, London WC1E 6HD, UK.
Hum Reprod. 2007 Jul;22(7):2020-4. doi: 10.1093/humrep/dem074. Epub 2007 Apr 20.
Various surgical and non-surgical treatment options are available for women with congenital vaginal agenesis. We report results of vaginal dilation therapy delivered by a multi-disciplinary team as first line treatment for vaginal agenesis.
Twenty-six women were recruited into a prospective observational study: 18 had Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH) and 8 had Complete Androgen Insensitivity Syndrome (CAIS). All women underwent a vaginal dilation programme co-ordinated by a clinical nurse specialist with input from a clinical psychologist. Vaginal length was compared to a normal reference range, and psycho-sexual questionnaires were completed before and after therapy.
Twenty-one (81%) patients completed the programme. Seventeen of these 21 (81%) were sexually active without any reported difficulties, whereas 4 were on a maintenance regime. In those who completed the programme the mean vaginal length increased from 4.0 to 8.5 cm and 86% achieved a vaginal length within the normal range. Subjective appraisal of vaginal size recorded that the number of women who reported that their vaginal size was 'more or less normal' increased from 1 to 12 following treatment. Questionnaire scores for sexual satisfaction and sexual depression improved in the CAIS group but did not alter significantly in the MRKH group.
Non-surgical dilation delivered by a multi-disciplinary team is an effective alternative to vaginal surgery and usually normalizes vaginal length.
对于先天性阴道闭锁的女性，有多种手术和非手术治疗选择。我们报告了由多学科团队提供的阴道扩张治疗作为阴道闭锁一线治疗的结果。
招募了26名女性参与一项前瞻性观察研究：18名患有 Mayer-Rokitansky-Kuster-Hauser 综合征（MRKH），8名患有完全雄激素不敏感综合征（CAIS）。所有女性都接受了由临床护士专家协调、临床心理学家参与的阴道扩张计划。将阴道长度与正常参考范围进行比较，并在治疗前后完成心理性问卷。
21名（81%）患者完成了该计划。这21名患者中有17名（81%）有性生活且无任何报告的困难，而4名处于维持治疗阶段。在完成该计划的患者中，平均阴道长度从4.0厘米增加到8.5厘米，86%的患者阴道长度达到正常范围。对阴道大小的主观评估显示，报告其阴道大小“或多或少正常”的女性人数在治疗后从1人增加到12人。CAIS组的性满意度和性抑郁问卷得分有所改善，但MRKH组没有显著变化。
由多学科团队进行的非手术扩张是阴道手术的有效替代方法，通常可使阴道长度恢复正常。
