Introduction and Objectives
The main goal in patients with vaginal agenesis (Mayer–Rokitansky–Küster–Hauser syndrome) is creation of a neovagina that will satisfy patient's needs and desire. We evaluated sexual and psychosocial adjustment in patients who underwent rectosigmoid vaginoplasty due to vaginal agenesis.
Material and Methods
We evaluated 22 women, aged 21 to 38 years (mean 26) who underwent rectosigmoid vaginoplasty. Sexual and psychosocial appraisal included the Female Sexual Function Index (FSFI), Beck's Depression Inventory (BDI) and standardized questionnaires about postoperative satisfaction, social and sexual adjustment.
Results
The mean follow-up was 5.3 years (range 5 months to 13 years). Two patients with no sexual intercourse were excluded from the study. Mean FSF Index (FSFI) was 29.4 (range 11.5–35.7) with cut-off score 26.55 for sexual dysfunction. Five (25%) of 20 women, reported sexual dysfunction. Mean Beck Depression Inventory (BDI) was 6.9 (cut-off score 0–9 for non-depression). A 14 women (70%) was without symptoms of depression, 4 (BDI ranged from 10–18) had moderate and two had severe depression (BDI 42). There were significant level (p < 0.01) within high satisfaction score in FSFI and low BDI results after completed statistical analysis. That indicates important predictive variable between one FSFI domain and psychological status. An 82% (18/22) of the patients believed that surgery was done at the right time and the most important postoperative support came from their family. A 91% of the patients reported satisfactory femininity with heterosexual orientation. 17 patients (77%) were satisfied with surgery, while 19 considered that this surgery is the best treatment.
Conclusions
Sexual function and psychosocial status of patients who underwent rectosygmoid vaginoplasty is not affected in general and achieved complete recovery. Predictive factor for sexual dysfunction is associated with lower orgasm score, while higher desire directly influences positive sexual function on the FSFI. Lack of depression and presence of sexual function precisely correlate with higher satisfaction. Multidisciplinary approach is essential for successful postoperative outcome and better quality of life.
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Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
