Leithner Katharina, Naderer Andrea, Hartung Dorothee, Abrahamowicz Clara, Alexopoulos Johanna, Walch Katharina, Wenzl René, Hilger Eva
Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria.
Department of Obstetrics and Gynaecology, Divison of Gynaecology and Gynaecological Oncology, Medical University Vienna, Vienna, Austria.
PLoS One. 2015 Apr 22;10(4):e0124604. doi: 10.1371/journal.pone.0124604. eCollection 2015.
Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) has a major impact on a woman's psychological and sexual well-being. In most of the studies that addressed treatment techniques, postoperative sexual function was reported to be satisfactory; however, comparatively few studies have additionally provided an accurate analysis of psychosocial functions in MRKHS patients following different kinds of neovaginal treatment. This study is to evaluate sexual and psychosocial functioning after creation of a neovagina according to Wharton-Sheares-George in women with MRKHS.
We performed a case-control-study using multiple measures to assess sexual and psychosocial functioning. Ten MRKHS patients and 20 controls of a University hospital and tertiary center for pediatric and adolescent gynecology were assessed. The follow-up assessment comprised 6 standardized questionnaires (Female Sexuality Function Index, FSFI; Patient Health Questionnaire, PHQ; Brief Symptom Inventory, BSI; World Health Organization Quality of Life Assessment, WHOQoL-BREF; Parental Bonding Instrument, PBI; and a German questionnaire on body image). The main outcome measures were sexual function, psychological status, quality of life, body image, and parental bonding styles.
Sexual function, psychological status (including depressive and somatic symptoms), quality of life, and own-body experience were at least as good in operated MRKHS patients as in controls. In some measures (FSFI, PHQ-15, psychological domain of the WHOQoL-BREF, and BSI Positive Symptom Total), patients scored significantly better than controls. The results of the PBI indicated a close and sustainable mother-daughter-relationship in MRKHS patients.
We found no evidence for an impairment of sexual or psychosocial functioning in patients after neovaginoplasty according to Wharton-Sheares-George. MRKHS may not necessarily compromise sexual and psychological well-being, provided that the syndrome is properly managed by a multidisciplinary team of health professionals.
Mayer-Rokitansky-Küster-Hauser综合征（MRKHS）对女性的心理和性健康有重大影响。在大多数涉及治疗技术的研究中，术后性功能据报道令人满意；然而，相对较少的研究还额外对不同类型新阴道治疗后的MRKHS患者的心理社会功能进行了准确分析。本研究旨在评估采用Wharton-Sheares-George法创建新阴道后，MRKHS女性的性功能和心理社会功能。
我们进行了一项病例对照研究，使用多种测量方法来评估性功能和心理社会功能。对一家大学医院及儿科和青少年妇科三级中心的10例MRKHS患者和20例对照者进行了评估。随访评估包括6份标准化问卷（女性性功能指数，FSFI；患者健康问卷，PHQ；简明症状量表，BSI；世界卫生组织生活质量评估，WHOQoL-BREF；父母教养方式问卷，PBI；以及一份关于身体意象的德语问卷）。主要结局指标为性功能、心理状态、生活质量、身体意象和父母教养方式。
接受手术的MRKHS患者的性功能、心理状态（包括抑郁和躯体症状）、生活质量和自身身体体验至少与对照者一样好。在某些测量指标（FSFI、PHQ-15、WHOQoL-BREF的心理领域以及BSI阳性症状总分）上，患者得分显著高于对照者。PBI的结果表明MRKHS患者中存在亲密且持久的母女关系。
我们没有发现证据表明采用Wharton-Sheares-George法进行新阴道成形术后患者的性功能或心理社会功能受损。如果由多学科健康专业团队对该综合征进行妥善管理，MRKHS不一定会损害性功能和心理健康。
