Dear Joanna, Creighton Sarah M, Conway Gerard S, Williams Louise, Liao Lih-Mei
Women's Health Division, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
Women's Health Division, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
J Pediatr Adolesc Gynecol. 2019 Jun;32(3):300-304. doi: 10.1016/j.jpag.2018.12.005. Epub 2018 Dec 21.
To summarize the self-reported sexual experiences of women with vaginal agenesis before treatment and discuss the clinical implications.
A retrospective review of pretreatment baseline sexuality data and medical records of women with vaginal agenesis seeking vaginal construction.
A specialist multidisciplinary center for women with genital differences associated with diverse sex development.
One hundred thirty-seven women with untreated vaginal agenesis associated with Mayer-Rokitansky-Küster-Hauser Syndrome and complete androgen insensitivity syndrome aged 15 to 41 years (mean age, 20 years).
Gynecological examination and completion of questionnaires.
(1) Sexual Experiences Questionnaire; (2) Multidimensional Sexuality Questionnaire; (3) Vaginal Self-Perceptions; and (4) vaginal length.
A sizable proportion of women reported having had sexually intimate experiences before any medical intervention on the vagina. Vaginal length, which ranged from dimple to 7 cm and averaged 2.7 cm for the cohort, was unrelated to the range of sexual experiences. Most women perceived their vagina as being too small, but less than half believed that a sexual partner would notice this. Two-thirds of the cohort subsequently completed the dilation program, which was not predicted by pretreatment vaginal length or sexual experience.
Contrary to the assumption that a vagina of certain dimensions is a prerequisite for women to "have sex," many women with Mayer-Rokitansky-Küster-Hauser syndrome and complete androgen insensitivity syndrome reported having experienced genital and nongenital sexual activities with no medical interventions. It is recommended that treatment providers affirm women's capacity for sexual intimacy, relationships, and enjoyment before they introduce the topic of vaginal construction as a non-urgent choice.
总结阴道发育不全女性治疗前自我报告的性经历，并探讨其临床意义。
对寻求阴道重建的阴道发育不全女性的治疗前基线性数据和病历进行回顾性研究。
一个针对与不同性发育相关的生殖器差异女性的多学科专科中心。
137名年龄在15至41岁（平均年龄20岁）、患有与 Mayer-Rokitansky-Küster-Hauser 综合征及完全雄激素不敏感综合征相关的未经治疗的阴道发育不全的女性。
妇科检查及问卷填写。
（1）性经历问卷；（2）多维性问卷；（3）阴道自我认知；（4）阴道长度。
相当一部分女性报告在对阴道进行任何医学干预之前就有过性亲密经历。阴道长度从凹痕到7厘米不等，该队列平均为2.7厘米，与性经历范围无关。大多数女性认为自己的阴道太小，但不到一半的人认为性伴侣会注意到这一点。该队列中有三分之二的女性随后完成了扩张程序，这无法通过治疗前的阴道长度或性经历来预测。
与认为特定尺寸的阴道是女性“进行性行为”的先决条件这一假设相反，许多患有 Mayer-Rokitansky-Küster-Hauser 综合征和完全雄激素不敏感综合征的女性报告在没有医学干预的情况下经历过生殖器和非生殖器性活动。建议治疗提供者在将阴道重建作为非紧急选择引入话题之前，肯定女性进行性亲密、建立关系和享受性爱的能力。
