Treatment for vaginal agenesis: A prospective and comparative study between vaginal dilation and surgical neovaginoplasty

Objective To compare, in terms of anatomical, functional, and sexual aspects, two types of treatment for women with vaginal agenesis: progressive dilation or surgical neovaginoplasty. Methods Women with vaginal agenesis underwent either dilation treatment using the Frank method or surgical treatment using the modified Abbe-McIndoe technique with oxidized cellulose. Patients were evaluated 3-6 months after treatment for a follow-up including medical history, physical examination, general satisfaction, clinical aspect of the vagina, Female Sexual Function Index, and three-dimensional pelvic floor ultrasound. Results In total, 20 women with vaginal agenesis were included in the present study; nine in the dilation group and 11 in the surgical group. A comparison between the groups (vaginal dilation and surgical neovaginoplasty) showed efficacy in neovagina formation after both treatments, with a statistically significant difference between the pre- and post-treatment periods (P value pre- x post-dilation group P value pre- x post-surgical group <0.0001). There were no statistical differences in total vaginal length measurements (P value post-dilation x post-surgical = 0.09) or Female Sexual Function Index scores (P = 0.72) after both treatments. Conclusion Both treatments had satisfactory efficacy and positive outcomes for patients with vaginal agenesis concerning anatomical, functional, and sexual aspects, with minimum complications in the surgical group. Dilation treatment can remain the first-line therapy.

Automated summary

The study compared the effectiveness of progressive dilation and surgical neovaginoplasty for women with vaginal agenesis in terms of anatomical, functional, and sexual aspects. Both treatments showed satisfactory efficacy with statistically significant improvement in neo-vagina formation. Neither treatment had statistical differences in total vaginal length measurements or Female Sexual Function Index scores.