Obstetrics and Gynecology Hospital, Fudan University, Huangpu District, Fangxie Road 419, Shanghai, 200011, China.
The Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, 200011, China.
Int Urogynecol J. 2022 Mar;33(3):723-729. doi: 10.1007/s00192-022-05075-y. Epub 2022 Jan 14.
The negative psychological impact on women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is long-lasting, resulting from not only the disease itself, but also the cumbersome and painful treatment process. However, little is known about the postoperative psychological status of these patients and related interventions to improve mental health. Here, in our study, we postulated that mental disorders exist in MRKH patients with a surgical neovagina and that psychological intervention will be helpful.
Thirty MRKH women who had undergone vaginoplasty were enrolled. All patients had received psychological interventions since February 2020. Depression and anxiety questionnaires prior to and 2 weeks after the final intervention were recorded.
Before intervention, among 30 MRKH patients after artificial vaginoplasty, the median depression score was 6.00 (25th/75th percentile, 0.00/7.00), and the median anxiety score was 4.00 (25th/75th percentile, 1.00/7.00). After intervention, women's depression (p < 0.001) and anxiety (p < 0.001) scores significantly decreased. The median depression score was 0.00 (25th/75th percentile, 0.00/3.00), and the median anxiety score was 1.00 (25th/75th percentile, 0.00/3.25). Furthermore, stratified analysis found that the depression (p = 0.029) and anxiety (p = 0.019) scores both improved when intervention was performed within 12 months postoperatively.
MRKH patients are at a great risk of depression and anxiety problems after artificial vaginoplasty. Early psychological intervention can alleviate these symptoms. Ongoing psychological support was needed to eliminate emotional burden during MRKH treatment, and further study is sorely needed to identify its appropriate timing and method.
Mayer-Rokitansky-Küster-Hauser（MRKH）综合征女性不仅受到疾病本身的影响，还受到繁琐和痛苦的治疗过程的影响，其负面心理影响是持久的。然而，对于这些患者的术后心理状态以及改善心理健康的相关干预措施知之甚少。在这里，我们假设存在手术阴道成形术后的 MRKH 患者存在精神障碍，而心理干预将有所帮助。
纳入 30 名接受过阴道成形术的 MRKH 女性。所有患者自 2020 年 2 月以来均接受了心理干预。记录最终干预前和 2 周后的抑郁和焦虑问卷。
在干预前，30 名接受人工阴道成形术的 MRKH 患者中，中位数抑郁评分为 6.00（25 分位数/75 分位数，0.00/7.00），中位数焦虑评分为 4.00（25 分位数/75 分位数，1.00/7.00）。干预后，女性的抑郁（p<0.001）和焦虑（p<0.001）评分明显降低。中位数抑郁评分为 0.00（25 分位数/75 分位数，0.00/3.00），中位数焦虑评分为 1.00（25 分位数/75 分位数，0.00/3.25）。此外，分层分析发现，术后 12 个月内进行干预时，抑郁（p=0.029）和焦虑（p=0.019）评分均有改善。
MRKH 患者在人工阴道成形术后有患抑郁和焦虑问题的高风险。早期心理干预可以缓解这些症状。需要持续的心理支持，以消除 MRKH 治疗期间的情绪负担，并且迫切需要进一步研究以确定其适当的时机和方法。
