Vaginal Agenesis and Congenital Adrenal Hyperplasia Psychosocial Sequelae of Diagnosis and Neovagina Formation

Abstract

Eleven patients with Mayer-Rokitansky-Küster syndrome (MRK) and 7 patients with adrenogenital syndrome (CVAH) were interviewed and tested pre- and postoperatively. MRK subjects were operated on with a modified Vecchietti procedure, CVAH subjects underwent genitoplastic and clitoroplastic operation. Psychosocial sequelae of and coping with malformation and treatment were assessed with semistructured interviews and the Giessen test. Anatomical and functional results of the vaginoplastic operation were excellent, and sexual satisfaction correlated with coping. 7/11 MRK patients were capable of good to fair adaptation to the malformation, whereas CVAH patients suffered severe distortions of body image. The malformation caused narcissistic damage in all cases. Circumstances of diagnosis, prevailing defense mechanism and consequences for counselling are discussed.

Assessment of Sexual Functioning, Mental Health, and Life Goals in Women with Vaginal Agenesis

“…Using three case studies of women with vaginal agenesis, they determined that similar physiologic sexual arousal occurred in patients with vaginal agenesis as for those without the disorder. Further research evaluating physiological sexual functioning following surgery has also indicated generally satisfactory physiologic sexual arousal and excitement responses of women with vaginal agenesis (e.g., Freundt, Toolenaar, Huikeshoven, Jeekel, & Drogendijk, 1993;Frost-Arner, Aberg, & Jacobsson, 2004;Kim et al, 2002;Langer, Grunberger, & Ringler, 1990;Mobus et al, 1996). Additionally, men who have previously experienced intercourse with women without vaginal agenesis have reported no difference in feeling between their current partner who underwent surgery and past partners without the condition (Mobus et al, 1996;Poland & Evans, 1985).…”

Long-term results of sigmoid vaginoplasty in a consecutive series of 62 patients

“…Because of amenorrhoea and problems with intercourse, the diagnosis is often made during adolescence [1,2]. The abrupt diagnosis of MRKHS in adolescent years, when the self-image is formed, has a considerable impact on a young woman's emotional stability [3]. In this period, anomalies of sexual organs may lead to profound identity problems, to a disturbed body image and to a low selfesteem due to the inability to conceive [3,4].…”

“…The abrupt diagnosis of MRKHS in adolescent years, when the self-image is formed, has a considerable impact on a young woman's emotional stability [3]. In this period, anomalies of sexual organs may lead to profound identity problems, to a disturbed body image and to a low selfesteem due to the inability to conceive [3,4]. In these patients, vaginal re-construction has positive effects on sexual activity, self-esteem and body image thus improving the overall quality of life [4,5].…”

Evaluation of vaginal agenesis treated with the modified McIndoe technique: A retrospective study

“…Abnormalities of sexual organs during this period may cause personality problems and poor body image. Also, inability to get pregnant during adulthood may cause low self-confidence (5,6). There are several nonsurgical and surgical methods for treatment of vaginal agenesis.…”