Our Summary

This research paper discusses a rare condition called “vaginal agenesis,” which affects around 1 in 5000 female births. This condition involves the failure of certain parts of the female reproductive system to develop, which can result in the absence of a vagina. The main cause of this is a syndrome called Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH), followed by a condition called androgen insensitivity syndrome. Treatment can range from non-surgical methods to more complex surgeries that create an artificial vagina. The paper talks about a patient who was born with male reproductive organs but was raised as a female, and who underwent surgery to remove the male organs and create a vagina using a procedure called a sigmoid vaginoplasty.

FAQs

  1. What is vaginal agenesis and how frequently does it occur?
  2. What is the most common cause of vaginal absence?
  3. What treatments are available for patients with vaginal absence, such as those with Mayer-Rokitansky-Kuster-Hauser syndrome or complete or partial androgen insensitivity syndrome?

Doctor’s Tip

One helpful tip a doctor might tell a patient about vaginoplasty is to carefully follow all pre-operative and post-operative instructions provided by the surgical team. This may include guidelines for physical activity, hygiene, and medications to help ensure a successful recovery and optimal outcomes. It is important to communicate openly with your healthcare provider about any concerns or questions you may have throughout the process.

Suitable For

Patients who are typically recommended vaginoplasty include those with vaginal agenesis, Mayer-Rokitansky-Kuster-Hauser syndrome, complete or partial androgen insensitivity syndrome, and testicular feminising syndrome. These patients may experience physical or psychological discomfort due to the absence of a vagina, and may benefit from surgical creation of a neovagina to improve their quality of life.

Timeline

Before Vaginoplasty:

  • Patient is diagnosed with vaginal agenesis, typically in adolescence or early adulthood.
  • Patient may experience psychological and emotional distress due to the absence of a vagina and potential implications on sexual function and fertility.
  • Patient may undergo counseling and evaluation to determine the best treatment approach for their individual case, which may include non-operative dilation or surgical creation of a neovagina.

After Vaginoplasty:

  • Patient undergoes bilateral gonadal excision and sigmoid vaginoplasty procedure.
  • Patient undergoes post-operative care and recovery, which may include pain management, wound care, and follow-up appointments with healthcare providers.
  • Patient experiences physical changes in their genital anatomy and may need to learn how to care for and maintain their neovagina.
  • Patient may undergo additional counseling or therapy to address any emotional or psychological issues related to their surgery and recovery.
  • Patient may experience improved sexual function and satisfaction, as well as increased self-esteem and confidence in their body.

What to Ask Your Doctor

  1. What are the different surgical options for vaginoplasty and which one would be most suitable for me?
  2. What are the potential risks and complications associated with vaginoplasty?
  3. What is the recovery process like after vaginoplasty and how long is the recovery period?
  4. Will I need to undergo any additional procedures or treatments before or after the vaginoplasty surgery?
  5. How will vaginoplasty impact my sexual function and sensation?
  6. Will I need to follow any specific post-operative care instructions or attend follow-up appointments?
  7. What are the chances of the vaginoplasty procedure being successful in creating a functional vagina?
  8. Are there any long-term effects or considerations I should be aware of after undergoing vaginoplasty?
  9. How experienced are you in performing vaginoplasty procedures and what is your success rate?
  10. Are there any alternative treatment options for vaginal agenesis that I should consider before deciding on vaginoplasty?

Reference

Authors: Sinha RJ, Bhaskar V, Mehrotra S, Singh V. Journal: BMJ Case Rep. 2016 Feb 12;2016:bcr2015213705. doi: 10.1136/bcr-2015-213705. PMID: 26873917