SUMMARY Additive Manufacturing (AM), also known as Rapid Prototyping, is a set of production technologies used in the synthesis of a particular physical object by adding layers to form a part based on data generated by Computer-Aided Design (CAD) systems. These technologies are widely used to quickly create prototypes of products and tools for commercial purposes. Over time, it has also been integrated with other areas, such as healthcare, since these tools have allowed health professionals to assist in diagnoses, surgical planning, and synthesis of orthoses and prostheses for patient rehabilitation. OBJECTIVE: To develop models for the construction of dilators for the treatment of vaginal agenesis. METHODS: Use CAD software and create a physical model using AM to analyze the viability of its production in the elaboration of customized dilators for each patient. RESULTS: The production through AM provides an advantage in the development, facilitating physical alterations just by adjusting the three-dimensional models made by the software in a quick way, thus making the customization process viable. CONCLUSION: The proposed procedure for the manufacture of dilators presented good results and technological feasibility, indicating that it can be a good solution for the production and customization of gynecological devices.

Objective The aim of this study was to evaluate the use of vaginal molds, made with three-dimensional (3D) printing, for conservative treatment through vaginal dilation in patients with vaginal agenesis (VA). Methods A total of 16 patients with a diagnosis of VA (Mayer-Rokitansky-Küster-Hauser syndrome, total androgen insensitivity syndrome, and cervicovaginal agenesis) from the Federal University of São Paulo were selected. Device production was performed in a 3D printer, and the polymeric filament of the lactic polyacid (PLA) was used as raw material. A personalized treatment was proposed and developed for each patient. Results There were 14 patients who reached a final vaginal length of 6 cm or more. The initial total vaginal length (TVL) mean (SD) was 1.81(1.05) and the final TVL mean (SD) was 6.37 (0.94); the difference, analyzed as 95% confidence interval (95% CI) was 4.56 (5.27–3.84) and the effect size (95% CI) was 4.58 (2.88–6.28). Conclusion The 3D printing molds for vaginal dilation were successful in 87.5% of the patients. They did not present any major adverse effects and offered an economical, accessible, and reproducible strategy for the treatment of VA.

Objective: The aim of this study was to evaluate the use of vaginal molds, made with three-dimensional (3D) printing, for conservative treatment through vaginal dilation in patients with Vaginal Agenesis (VA). Methods: Sixteen patients with a diagnosis of VA (Mayer-Rokitansky-Küster-Hauser syndrome, Total Androgen Insensitivity Syndrome and cervicovaginal agenesis), from Federal University of São Paulo, were selected. The production of the devices was carried out in a 3D printer and, as raw material, the polymeric filament of the lactic polyacid (PLA) was used. A personalized treatment was proposed and developed for each patient.Results: Fourteen patients reached a final vaginal length of 6 cm or more. The initial TVL Mean (SD) was 1,81(1,05) and the final TVL Mean (SD) 6,37(0,94); the Difference (IC-95%) was 4,56 (5,27 - 3,84) and the Effect size (IC-95%) was 4,58 (2,88 – 6,28). Therefore, there was a significant difference (P<0.05) between the initial and final measurements. The Effect Size was 4.58, reinforcing the great magnitude of this difference. Conclusion: The present study has shown the fruitful applicability of the devices, which offers an economical, accessible, promissing and reproducible strategy for the treatment of VA.

Introduction: The use of tridimensional (3D) printing in healthcare has contributed to the development of instruments and implants. The 3D printing has also been used for teaching future professionals. In order to have a good 3D printed piece, it is necessary to have high quality images, such as the ones from Computerized Tomography (CT scan) exam, which shows the anatomy from different cuts and allows for a good image reconstruction.Purpose: To propose a protocol for creating digital files from computerized tomography images to be printed in 3D and used as didactic material in the ophthalmology field, using open-source software, InVesalius®, Blender® and Repetier-Host©.Methods: Two orbit CT scan exam images in the DICOM format were used to create the virtual file to be printed in 3D. To edit the images, the software InVesalius® (Version 3.1.1) was used to delimit and clean the structure of interest, and also to convert to STL format. The software Blender® (Version 2.80) was used to refine the image. The STL image was then sent to the Repetier-Host© (Version 2.1.3) software, which splits the image in layers and generates the instructions to print the piece in the 3D printer using the polymer polylactic acid (PLA). Results:The printed anatomical pieces printed reproduced most structures, both bone and soft structures, satisfactorily. However, there were some problems during printing, such as the loss of small bone structures, that are naturally surrounded by muscles due to the lack of support. Conclusion:Despite the difficulties faced during the production of the pieces, it was also possible to reproduce the anatomical structures adequately, which indicates that this protocol of 3D printing from medical images is viable.

A agenesia vaginal é uma malformação congênita do trato reprodutivo das mulheres causada por uma anomalia na formação dos ductos paramesonéfricos (Müller), que são responsáveis por originar os órgãos genitais internos no sexo feminino. Os dilatadores vaginais têm como objetivo promover a dilatação e conscientização da musculatura do assoalho pélvico em mulheres com alguma disfunção nesta área por meio de tratamento de caráter progressivo. Particularmente entre mulheres com agenesia vaginal, a criação de dilatadores vaginais personalizados à sua própria anatomia, com auxílio de impressão 3D, pode ser uma excelente alternativa terapêutica.