Materiały źródłowe

• #1 Müllerian Agenesis: Diagnosis, Management, and Treatment | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/01/mullerian-agenesis-diagnosis-management-and-treatment

  Mllerian agenesis, also referred to as mllerian aplasia, Mayer-Rokitansky-Kster-Hauser syndrome, or vaginal agenesis, has an incidence of 1 per 4,5005,000 females. […] The most important steps in the effective management of mllerian agenesis are correct diagnosis of the underlying condition, evaluation for associated congenital anomalies, and psychosocial counseling in addition to treatment or intervention to address the functional effects of genital anomalies. […] All patients with mllerian agenesis should be offered counseling and encouraged to connect with peer support groups. […] Future options for having children should be addressed with patients: options include adoption and gestational surrogacy. […] Primary vaginal elongation by dilation is the appropriate first-line approach in most patients because it is safer, patient-controlled, and more cost effective than surgery.

• #2

  https://www.amerikanhastanesi.org/mayo-clinic-care-network/mayo-clinic-health-information-library/diseases-conditions/vaginal-agenesis

  Vaginal agenesis (a-JEN-uh-sis) is a rare disorder in which the vagina doesn’t develop, and the womb (uterus) may only develop partially or not at all. This condition is present before birth and may also be associated with kidney or skeletal problems. […] Vaginal agenesis is often identified at puberty when a female does not begin menstruating. Use of a vaginal dilator, a tubelike device that can stretch the vagina when used over a period of time, is often successful in creating a vagina. In some cases, surgery may be needed. Treatment makes it possible to have vaginal intercourse. […] Treatment for vaginal agenesis often occurs in the late teens or early 20s, but you may wait until you’re older and you feel motivated and ready to participate in treatment. […] Self-dilation is typically recommended as the first option. Self-dilation may allow you to create a vagina without surgery. The goal is to lengthen the vagina to a size comfortable for sexual intercourse.

• #3 ACOG Committee Opinion No. 355: Vaginal agenesis: diagnosis, management, and routine care – PubMed

  https://pubmed.ncbi.nlm.nih.gov/17138802/

  Vaginal agenesis occurs in 1 of every 4,000-10,000 females. The most common cause of vaginal agenesis is congenital absence of the uterus and vagina, which also is referred to as mllerian aplasia, mllerian agenesis, or Mayer-Rokitansky-Kster-Hauser syndrome. The condition usually can be successfully managed nonsurgically with the use of successive dilators if it is correctly diagnosed and the patient is sufficiently motivated. […] Besides correct diagnosis, effective management also includes evaluation for associated congenital renal or other anomalies and careful psychologic preparation of the patient before any treatment or intervention. […] If surgery is preferred, a number of approaches are available; the most common is the Abbe-McIndoe operation. Women who have a history of mllerian agenesis and have created a functional vagina require routine gynecologic care and can be considered in a similar category to that of women without a cervix and thus annual cytologic screening for cancer may be considered unnecessary in this population.

• #4 Vaginal agenesis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vaginal-agenesis/symptoms-causes/syc-20355737

  Vaginal agenesis is often identified at puberty when a female does not begin menstruating. […] Use of a vaginal dilator, a tubelike device that can stretch the vagina when used over a period of time, is often successful in creating a vagina. In some cases, surgery may be needed. Treatment makes it possible to have vaginal intercourse. […] Vaginal agenesis may impact your sexual relationships, but after treatment, your vagina will typically function well for sexual activity. […] Discuss fertility options with your health care provider.

• #5 Mullerian Duct Anomalies: Overview, Incidence and Prevalence, Embryology

  https://emedicine.medscape.com/article/954110-treatment

  Mllerian agenesis, also termed mllerian aplasia, is characterized by an absence or hypoplasia of the uterus, proximal vagina, and, in some cases, the fallopian tubes. The condition has been also referred to as the Mayer-Rokitansky-Kster-Hauser (MRKH) syndrome, when it occurs in its most extreme form, both uterine and vaginal aplasia. […] Mllerian agenesis can be partial or complete. Partial mllerian agenesis is more rarely encountered and is characterized by a normal uterus and small vaginal pouch distal to the cervix. Complete mllerian agenesis (MRKH syndrome) is the most common variant encountered, and it is characterized by congenital absence of the vagina and the uterus in 90-95% of cases. The fallopian tubes are normal, and the ovaries have normal endocrine and oocyte function. […] The first-line approach in most patients should be primary vaginal elongation by dilation. Compared with surgery, it is safer, patient-controlled, and more cost-effective.

• #5 Mullerian Duct Anomalies: Overview, Incidence and Prevalence, Embryology

  https://emedicine.medscape.com/article/954110-overview

  Mllerian agenesis, also termed mllerian aplasia, is characterized by an absence or hypoplasia of the uterus, proximal vagina, and, in some cases, the fallopian tubes. The condition has been also referred to as the Mayer-Rokitansky-Kster-Hauser (MRKH) syndrome, when it occurs in its most extreme form, both uterine and vaginal aplasia. […] Mllerian agenesis can be partial or complete. Partial mllerian agenesis is more rarely encountered and is characterized by a normal uterus and small vaginal pouch distal to the cervix. Complete mllerian agenesis (MRKH syndrome) is the most common variant encountered, and it is characterized by congenital absence of the vagina and the uterus in 90-95% of cases. The fallopian tubes are normal, and the ovaries have normal endocrine and oocyte function. […] The first-line approach in most patients should be primary vaginal elongation by dilation. Compared with surgery, it is safer, patient-controlled, and more cost-effective.

• #6 ACOG Committee Opinion No. 728: Müllerian Agenesis: Diagnosis, Management, And Treatment – PubMed

  https://pubmed.ncbi.nlm.nih.gov/29266078/

  Mllerian agenesis, also referred to as mllerian aplasia, Mayer-Rokitansky-Kster-Hauser syndrome, or vaginal agenesis, has an incidence of 1 per 4,500-5,000 females. […] The most important steps in the effective management of mllerian agenesis are correct diagnosis of the underlying condition, evaluation for associated congenital anomalies, and psychosocial counseling in addition to treatment or intervention to address the functional effects of genital anomalies. […] The psychologic effect of the diagnosis of mllerian agenesis should not be underestimated. All patients with mllerian agenesis should be offered counseling and encouraged to connect with peer support groups. […] Nonsurgical vaginal elongation by dilation should be the first-line approach. When well-counseled and emotionally prepared, almost all patients (90-96%) will be able to achieve anatomic and functional success by primary vaginal dilation. […] In cases in which surgical intervention is required, referrals to centers with expertise in this area should be considered because few surgeons have extensive experience in construction of the neovagina and surgery by a trained surgeon offers the best opportunity for a successful result.

• #7 Vaginal Agenesis: Symptoms & Treatment – Dr. Neelima Mantri

  https://www.drneelimamantri.com/blog/vaginal-agenesis-symptoms-treatment/

  Vaginal Agenesis is a congenital abnormality where the foetus is born with an underdeveloped vagina. […] Vaginal Agenesis is a congenital abnormality where the vagina of the foetus may not fully develop to be a normal one. […] More often than not this condition develops in tandem with other abnormalities of the reproductive system like underdeveloped fallopian tubes, or uterus, even spine and kidney growth problems too, says the best lady gynaecologist in Mumbai, Dr Neelima Mantri. […] In some cases, the outer organs appear normal and hence this condition may not be identified at birth in some cases. So unable to have menstruation is only the symptom in such cases that may signal Vaginal Agenesis. This condition is called Amenorrhea. […] Pain during sex is another symptom which is caused due to shorted vagina.

• #7 Vaginal Agenesis: Symptoms & Treatment – Dr. Neelima Mantri

  https://www.drneelimamantri.com/blog/vaginal-agenesis-symptoms-treatment/

  A physical exam, ultrasound and MRI followed by a blood test and DNA test (for chromosomal abnormalities) are performed to identify and build the plan of treatment for Vaginal Agenesis. […] Self-dilation is recommended in cases of the vaginal dimple. A hard and smooth tampon-shaped plastic tube is used to slowly dilate the vagina with pressure for 15-20 minutes a day until the vaginal attains a normal shape. […] Vaginoplasty is considered by the gynaecologist to construct the vaginal canal. It is created using skin from the insides of the cheek or bowel along with a placeholder to make it stay intact in shape.

• #8 Care and Counseling of the Patient with Vaginal Agenesis | Intersex Society of North America

  https://isna.org/node/83/

  Vaginal agenesis involves issues of physical abnormality, body image, sexual identity, and sexual/reproductive functioning that require long-term medical and psychological management. The authors detail the nonsurgical Frank procedure for creating a vagina and discuss counseling techniques for the patient and her family. […] Vaginal agenesis, which occurs in approximately 1 in every 5,000 to 7,000 female births, is a significant threat to the mental health and well-being of an otherwise normal, healthy young woman. […] Professional counseling of the patient and her parents should begin shortly after the abnormality is recognized. […] Early referral for counseling is essential for all of these patients to help them deal with issues of inadequacy, gender/sexual identity and functioning, and motherhood.

• #9 Vaginal agenesis – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/vaginal-agenesis/

  If self-dilation doesn’t work, surgery to create a functional vagina (vaginoplasty) may be an option. […] After surgery, use of a mold, dilation or frequent sexual intercourse is needed to maintain a functional vagina. Health care providers usually delay surgical treatments until you feel prepared and able to handle self-dilation. Without regular dilation, the newly created vaginal canal can quickly narrow and shorten, so being emotionally mature and ready to comply with aftercare is critically important. […] Learning you have vaginal agenesis can be difficult. That’s why your health care provider will recommend that a psychologist or social worker be part of your treatment team. These mental health providers can answer your questions and help you deal with some of the more difficult aspects of having vaginal agenesis, such as possible infertility.

• #10 What Is Vaginal Agenesis – Klarity Health Library

  https://my.klarity.health/what-is-vaginal-agenesis/

  Post-surgery care is incredibly important to the individual’s recovery. To maintain results, the patient typically must use the vaginal dilator for 3-6 months, because it can help to stretch the vaginal opening. […] Being diagnosed and coping with vaginal agenesis can be very difficult for anyone, but especially for adolescents. It is important for the patient to have a psychologist or social worker working alongside the treatment team to help cope with the challenging aspects of the condition, such as the possibility of infertility. […] Vaginal agenesis can have an impact on the sexual relationship of an individual, causing them to have a lot of pain and discomfort during sex. After treatment, the person can have sexual activity. […] With vaginal agenesis being a difficult condition to live with, many psychological support groups can help the patient to better understand the condition and connect to others that also have it.

• #11 Care and Counseling of the Patient with Vaginal Agenesis | Intersex Society of North America

  https://isna.org/node/83/

  The patient should be told that she was born with an incompletely developed vagina; the expression „born without a vagina” should be avoided. […] The physician and counselor should try to anticipate and raise questions that may be on the child’s or parents’ minds rather than waiting to be asked-but care should be taken not to „force-feed” the child overwhelming amounts of information. […] The adolescent patient and her parents will need a complete understanding of the available treatment options. […] The nonsurgical Frank procedure and the McIndoe split-thickness skin-graft vaginoplasty should be discussed as alternatives. […] The importance of referral to a certified sex therapist cannot be overemphasized, since the physician and counselor form complementary relationships with the patient. […] These professionals have different areas of expertise, and together they play an important role in the well-being of the patient.

• #12 Duzce Medical Journal » Submission » Diagnosis and Treatment Approaches in Vaginal Agenesis

  https://dergipark.org.tr/en/pub/dtfd/issue/86226/1531224

  The psychosexual effects of vaginal agenesis should not be overlooked, and clinical care primarily involves comprehensive counseling and support through open communication with the patient. […] For adult patients, treatment for vaginal agenesis typically starts with therapeutic counseling and education, with non-invasive vaginal dilation being recommended as the first-line approach, or surgery if necessary. […] Consequently, managing these issues often requires a multidisciplinary approach, engaging specialists such as urologists, gynecologists, endocrinologists, and geneticists, among others. […] Early detection and timely intervention can greatly enhance the outlook for individuals with these conditions. […] Besides considering the patient’s expectations, the surgeon’s experience plays a crucial role in selecting the appropriate surgical technique. […] This is because the success of the initial surgery is critical to the effectiveness of any subsequent procedures if required. […] In this review, the evaluation and treatment of vaginal agenesis, which constitutes an important part of congenital anomalies of the vagina, were discussed.

• #13 (PDF) Care and Counseling of the Patient With Vaginal Agenesis

  https://www.academia.edu/127517454/Care_and_Counseling_of_the_Patient_With_Vaginal_Agenesis

  Vaginal agenesis involves issues of physical abnormality, body image, sexual identity, and sexual/reproductive functioning that require long-term medical and psychological management. The authors detail the nonsurgical Frank procedure for creating a vagina and discuss counseling techniques for the patient and her family. […] Overall, the management of vaginal agenesis requires a multidisciplinary approach to fully support these patients from initial diagnosis, through management decision-making and long-term follow-up, through transition to adulthood. […] The most common issue leading to early discontinuation was lack of patient motivation and readiness. […] The most common complication was pain or discomfort. […] More than half of respondents determined dilator therapy was successful when patients reported comfortable sexual intercourse.

• #14 Müllerian Agenesis: Diagnosis, Management, and Treatment | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/01/mullerian-agenesis-diagnosis-management-and-treatment

  When well-counseled and emotionally prepared, almost all patients (9096%) will be able to achieve anatomic and functional success by primary vaginal dilation. […] Regardless of the surgical technique chosen, referrals to centers with expertise should be offered. […] Patients should be given a written medical summary of their condition, including a summary of concomitant malformations. […] Management of patients with mllerian agenesis includes psychosocial counseling as well as treatment of the anatomic anomalies. Options include vaginal elongation and the surgical creation of a neovagina. […] Surgical creation of a vagina requires ongoing postoperative dilation or vaginal intercourse to maintain adequate vaginal length and diameter; therefore, it is not a method to avoid vaginal dilator therapy.

• #15 Vaginal agenesis | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20253613/

  Vaginal agenesis is often identified at puberty when a female does not begin menstruating. […] Use of a vaginal dilator, a tubelike device that can stretch the vagina when used over a period of time, is often successful in creating a vagina. In some cases, surgery may be needed. Treatment makes it possible to have vaginal intercourse. […] Treatment for vaginal agenesis often occurs in the late teens or early 20s, but you may wait until you’re older and you feel motivated and ready to participate in treatment. […] You and your health care provider can discuss treatment options. Depending on your individual condition, options may involve no treatment or creating a vagina by self-dilation or surgery. […] Self-dilation is typically recommended as the first option. Self-dilation may allow you to create a vagina without surgery. The goal is to lengthen the vagina to a size comfortable for sexual intercourse.

• #16 Vaginal agenesis – Hancock Health

  https://www.hancockhealth.org/mayo-health-library/vaginal-agenesis/

  Vaginal agenesis is often identified at puberty when a female does not begin menstruating. […] Use of a vaginal dilator, a tubelike device that can stretch the vagina when used over a period of time, is often successful in creating a vagina. In some cases, surgery may be needed. Treatment makes it possible to have vaginal intercourse. […] Vaginal agenesis may impact your sexual relationships, but after treatment, your vagina will typically function well for sexual activity. […] You and your health care provider can discuss treatment options. Depending on your individual condition, options may involve no treatment or creating a vagina by self-dilation or surgery. […] Self-dilation is typically recommended as the first option. Self-dilation may allow you to create a vagina without surgery. The goal is to lengthen the vagina to a size comfortable for sexual intercourse.

• #17 Vaginal agenesis | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20253613/

  Discuss the process of self-dilation with your health care provider so that you know what to do and talk about dilator options to find what works best for you. […] If self-dilation doesn’t work, surgery to create a functional vagina (vaginoplasty) may be an option. […] After surgery, use of a mold, dilation or frequent sexual intercourse is needed to maintain a functional vagina. Health care providers usually delay surgical treatments until you feel prepared and able to handle self-dilation. Without regular dilation, the newly created vaginal canal can quickly narrow and shorten, so being emotionally mature and ready to comply with aftercare is critically important.

• #18 Vaginal Agenesis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/23458-vaginal-agenesis

  If you have a vaginal opening or a dimple where the opening should be, your provider may recommend using a dilator to create a vagina. You use a small tube to make an opening and gradually increase the size every day. This usually takes about 20 minutes a day. The dilation may feel uncomfortable, but it shouldnt hurt. […] Your provider may recommend a procedure called a vaginoplasty to construct a vaginal canal. The technique your provider uses will depend on your anatomy and several other factors. Providers can create a vagina by placing a traction device on the absent vagina, using a skin graft or the skin from the inside of your cheek or a portion of your bowel (intestine). […] After treatment, many people have a satisfying sex life. Your partner may not even notice that you had vaginal agenesis or received treatment for the condition.

• #19 Vaginal agenesis // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/vaginal-agenesis

  Vaginal dilation through frequent intercourse is an option for self-dilation for women who have willing partners. […] If self-dilation doesn’t work, surgery to create a functional vagina (vaginoplasty) may be an option. […] After surgery, use of a mold, dilation or frequent sexual intercourse is needed to maintain a functional vagina. […] Health care providers usually delay surgical treatments until you feel prepared and able to handle self-dilation. […] Talk to your health care provider about the best surgical option to meet your needs, and the risks and required care after surgery.

• #20 Mullerian Duct Anomalies: Overview, Incidence and Prevalence, Embryology

  https://emedicine.medscape.com/article/954110-overview

  Surgery should be reserved for the rare patient who is unsuccessful with primary dilator therapy or who prefers surgery after a thorough informed consent discussion with her gynecologic care provider and her respective parent(s) or guardian(s). Primary vaginal dilation is successful for more than 90-96% of patients. […] The aim of surgical treatment is to create a neovagina. Although several vaginoplasty methods have been developed, refined, and modified, no definitive surgical approach has been established. […] The modified McIndoe procedure remains the most common surgical approach to vaginoplasty. […] The patient is prescribed antibiotics and a low-residue diet. She is gradually allowed to ambulate within 24 hours after surgery, but she must remain on bedrest in upright and flat positions for 1 week.

• #21

  https://journals.lww.com/greenjournal/fulltext/2018/01000/acog_committee_opinion_no__728_summary__m_llerian.35.aspx

  All patients with mllerian agenesis should be offered counseling and encouraged to connect with peer support groups. […] Primary vaginal elongation by dilation is the appropriate first-line approach in most patients because it is safer, patient-controlled, and more cost effective than surgery. […] Because primary vaginal dilation is successful for more than 9096% of patients, surgery should be reserved for the rare patient who is unsuccessful with primary dilator therapy or who prefers surgery after a thorough informed consent discussion with her gynecologic care provider and her respective parent(s) or guardian(s). […] Regardless of the surgical technique chosen, referrals to centers with expertise should be offered. The surgeon must be experienced with the procedure because the initial procedure is more likely to succeed than follow-up procedures.

• #22

  https://www.amerikanhastanesi.org/mayo-clinic-care-network/mayo-clinic-health-information-library/diseases-conditions/vaginal-agenesis

  If self-dilation doesn’t work, surgery to create a functional vagina (vaginoplasty) may be an option. Types of vaginoplasty surgery include: Using a tissue graft. […] After surgery, use of a mold, dilation or frequent sexual intercourse is needed to maintain a functional vagina. Health care providers usually delay surgical treatments until you feel prepared and able to handle self-dilation. Without regular dilation, the newly created vaginal canal can quickly narrow and shorten, so being emotionally mature and ready to comply with aftercare is critically important.

• #23 Treatment Options For Women With Vaginal Agenesis – Specialty Surgical Center

  https://specialtysurgerycenter.org/treatment-options-for-women-with-vaginal-agenesis/

  Vaginal agenesis is a complex condition that causes the muscular canal (vagina) within the pelvis to not form properly during fetal development. […] While physicians and researchers are still working on techniques to successfully transplant a healthy uterus into patients with vaginal agenesis, current treatment options for this condition depend on the severity of the disorder itself. […] Generally speaking, treatment for vaginal agenesis includes: […] Self-Dilation: Women with a dimple in the area where the vagina would be could use a small tube called dilator to create a vagina. […] Vaginoplasty With Skin Grafting: A vagina can be created using skin from the patients buttocks or artificial skin. […] Bowel Vaginoplasty: A vagina can be created removing part of the lower colon and inserting in the place where the vaginal opening would be.

• #24 Müllerian Agenesis: Diagnosis, Management, and Treatment | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/01/mullerian-agenesis-diagnosis-management-and-treatment

  The primary aim of surgery is the creation of a vaginal canal to allow penetrative intercourse. […] Surgical procedures often are performed in late adolescence or young adulthood when the patient is mature enough to agree to the procedure and to be able to adhere to postoperative dilation. […] The timing of the surgery depends on the patient and the type of procedure planned. […] The surgeon must be experienced with the procedure because the initial procedure is more likely to succeed than follow-up procedures. […] Postoperative dilation is essential to prevent significant neovaginal stenosis and contracture; therefore, these techniques are not recommended if the patient objects to dilation.

• #25 Mullerian Duct Anomalies: Overview, Incidence and Prevalence, Embryology

  https://emedicine.medscape.com/article/954110-treatment

  The aim of surgical treatment is to create a neovagina. Although several vaginoplasty methods have been developed, refined, and modified, no definitive surgical approach has been established. […] The modified McIndoe procedure remains the most common surgical approach to vaginoplasty. […] The patient is prescribed antibiotics and a low-residue diet. She is gradually allowed to ambulate within 24 hours after surgery, but she must remain on bedrest in upright and flat positions for 1 week. […] The neovagina is irrigated with warm sodium chloride solution and carefully inspected to determine whether the graft has taken satisfactorily. […] In summary, the McIndoe procedure is the most widely accepted surgical approach to mllerian aplasia. It is a highly successful procedure, and patient satisfaction is high. Although most patients cannot obtain full fertility, except through surrogates, they can have normal sexual relations.

• #26 Vaginal Agenesis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/23458-vaginal-agenesis

  If you have surgery, ask your provider what you can expect during recovery. You may need to stay off your feet for about a week. Your provider may recommend leaving a dilator inside your vagina for a few months. You can take the dilator out to have sex, go to the bathroom or take a shower. […] Ask your provider when you can safely have sex after treatment for vaginal agenesis. Usually, you can start having sex about a month after surgery, but everyones recovery time is different. You will need artificial lubrication to make sex comfortable at first. […] If you dont have a uterus (or if its too small), you may not be able to carry a child (uterine factor infertility). But you may be able to have a child with a surrogate using your own eggs. Your provider may refer you to a fertility specialist to discuss your options.

• #27 Mayo Clinic Health Library – Vaginal agenesis | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20253613

  If self-dilation doesn’t work, surgery to create a functional vagina (vaginoplasty) may be an option. […] After surgery, use of a mold, dilation or frequent sexual intercourse is needed to maintain a functional vagina. Health care providers usually delay surgical treatments until you feel prepared and able to handle self-dilation. Without regular dilation, the newly created vaginal canal can quickly narrow and shorten, so being emotionally mature and ready to comply with aftercare is critically important.

• #28 Mullerian Duct Anomalies: Overview, Incidence and Prevalence, Embryology

  https://emedicine.medscape.com/article/954110-overview

  Patient education regarding the importance of continuous, prolonged dilatation and stent care during the healing phase is important. […] The form is worn continuously for 6 weeks and is removed only for urination and defecation. Low-pressure douches with warm water are performed daily. […] In summary, the McIndoe procedure is the most widely accepted surgical approach to mllerian aplasia. It is a highly successful procedure, and patient satisfaction is high. Although most patients cannot obtain full fertility, except through surrogates, they can have normal sexual relations.

• #29 Vaginal Agenesis | Intimate Wellness Institute

  https://iwiva.com/home-page/womens-speciality-care/advanced-gynecology/congenital-abnormalities/vaginal-agenesis/

  Vaginal agenesis can be treated with medical devices that gradually dilate the vaginal canal. […] Sometimes, you need surgery to create a vaginal opening. […] Treatment for vaginal agenesis includes: Self-dilation of the vagina. […] If you have a vaginal opening or a dimple where the opening should be, the IWI team may recommend using a dilator to create a vagina. […] Dr. Guerette may recommend a procedure called a vaginoplasty or a neovagina to construct a vaginal canal depending on the specific issue. […] After the surgery, Dr. Guerette places an insert in the vagina to maintain its shape during early healing. […] Dr. Guerette will examine you to determine when you can safely have sex after treatment for vaginal agenesis. […] After treatment, many people have a satisfying sex life. […] If your uterus, fallopian tubes and cervix developed normally, you may still be able to have children. […] The IWI team may refer you to a fertility specialist to discuss your options.

• #30

  https://journals.lww.com/greenjournal/fulltext/2018/01000/acog_committee_opinion_no__728_summary__m_llerian.35.aspx

  Mllerian agenesis, also referred to as mllerian aplasia, Mayer-Rokitansky-Kster-Hauser syndrome, or vaginal agenesis, has an incidence of 1 per 4,5005,000 females. Mllerian agenesis is caused by embryologic underdevelopment of the mllerian duct, with resultant agenesis or atresia of the vagina, uterus, or both. Patients with mllerian agenesis usually are identified when they are evaluated for primary amenorrhea with otherwise typical growth and pubertal development. The most important steps in the effective management of mllerian agenesis are correct diagnosis of the underlying condition, evaluation for associated congenital anomalies, and psychosocial counseling in addition to treatment or intervention to address the functional effects of genital anomalies. The psychologic effect of the diagnosis of mllerian agenesis should not be underestimated. All patients with mllerian agenesis should be offered counseling and encouraged to connect with peer support groups. Future options for having children should be addressed with patients: options include adoption and gestational surrogacy. Assisted reproductive techniques with use of a gestational carrier (surrogate) have been shown to be successful for women with mllerian agenesis. Nonsurgical vaginal elongation by dilation should be the first-line approach. When well-counseled and emotionally prepared, almost all patients (9096%) will be able to achieve anatomic and functional success by primary vaginal dilation. In cases in which surgical intervention is required, referrals to centers with expertise in this area should be considered because few surgeons have extensive experience in construction of the neovagina and surgery by a trained surgeon offers the best opportunity for a successful result.

• #31 CARE Clinic – Expert Urogynecology Services at Northwestern Medicine

  https://urogynecology.nm.org/care-clinic.html

  We know that care for complex congenital anomalies can be confusing and stressful. […] Our care team includes: Surgeons who perform procedures for children, Physicians who specialize in child urology, Gynecologists who care for teenagers, Physicians with expertise in female pelvic issues (called urogynecologists). […] Conditions We Treat: Anomalies of the genital tract including: Not having a vagina (vaginal agenesis). […] Our team of experts is here for you. We evaluate and care for patients with congenital abnormalities of the genitourinary tract.

• #32 Müllerian Anomalies | Congenital Female Tract Abnormalities | Duke Health

  https://www.dukehealth.org/treatments/obstetrics-and-gynecology/mullerian-anomalies

  Vaginal agenesis, vaginal septum, and congenital uterine abnormalities often go undetected and may cause no symptoms. […] It is important that you are psychologically ready before pursuing treatment. […] Dilator treatment is often the first treatment recommended. […] Surgery to create a functional vagina may be performed when a young woman wants a longer, more functional vagina. […] When a wall of tissue, or a septum, forms an obstruction in the vagina, surgery may be performed to remove the tissue to form a single vaginal canal. […] A physical therapist who specializes in the pelvic floor may work with you to help manually stretch vaginal tissues or relax painful muscles.

• #33 Best Treatment for Vaginal Agenesis in Women, Hyderabad -Rainbow Children’s Hospital

  https://www.rainbowhospitals.in/doctors/vaginal-agenesis-in-women-hyderabad

  In addition to medical and surgical treatments, Rainbow Children’s Hospitals prioritize holistic care for women dealing with Vaginal Agenesis. BirthRight by Rainbow Hospitals, a specialized wing, provides psychological counseling and support services. These services aid patients in navigating the emotional challenges associated with the condition, fostering emotional well-being alongside physical recovery. […] In conclusion, Rainbow Children’s Hospitals and BirthRight by Rainbow Hospitals in Hyderabad stand as beacons of excellence in addressing Vaginal Agenesis in women. Their comprehensive approach, integrating personalized medical care, expert surgical procedures, and holistic support services, reflects their commitment to providing tailored and compassionate treatment options for women dealing with this condition.

• #34 MRKH Surgeons | Vaginal Agenesis | AIS | Neovagina Surgeons

  https://www.mrkh-surgeons.com/

  Mayer-Rokitansky-Kuster-Hauser Syndrome, also known as MRKH, is a condition when the uterus and vaginal canal do not form properly, a condition also called VAGINAL AGENESIS. […] The diagnosis is one that is very difficult for many young women emotionally to handle, however the good news is that there are treatment options to allow MRKH patients to achieve full vaginal length and a normal sexual life as well. […] Dr. Moore and Dr. Miklos are internationally renowned laparoscopic pelvic reconstructive surgeons who are board certified in Female Pelvic Medicine and Reconstructive Pelvic Surgery and specialize in the Laparoscopic Creation of a Neovagina in women born without a vagina or in women that have had surgical complications that has significantly shortened the vagina. […] This approach is one of the least invasive and safest approaches to create a vagina with the fastest recovery time and success rates over 95%. […] Their Center also offers a full level of support for young women diagnosed with MRKH including programs for mothers and daughters, educational videos and seminars, confidential counseling for patients and families, post-operative care, counseling and support.

• #35 Müllerian Agenesis: Room for Improvement in Care, Counseling – Research Horizons

  https://scienceblog.cincinnatichildrens.org/mullerian-agenesis-room-for-improvement-in-care-counseling/

  “Our findings show room for improvement in the counseling and care of individuals with MRKH, particularly around vaginal lengthening,” Pennesi says. “There is a need to educate healthcare providers so they can support patients in accessing appropriate, comprehensive and longitudinal care.” […] Pennesi and her team at the MRKH Care Center at Cincinnati Children’s aim to increase awareness about Müllerian agenesis among providers and provide comprehensive care to individuals with MRKH.

• #36 MRKH Syndrome in Children | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/mayer-rokitansky-kuster-hauser-syndrome/

  Vaginal dilation stretches the skin of the vaginal area to help create a vagina. There are many different types and sizes of dilators, but most are hard plastic and look like a candlestick. When you are ready for it, your doctor will teach you how to use the dilator and monitor your progress. […] In general, we advise starting treatment with vaginal dilation because it is effective, noninvasive, and is not associated with surgical risks. […] Surgical creation of the vagina, also known as vaginoplasty, requires general anesthesia and is usually maintained with vaginal dilation after surgery. There are several methods to surgically create a vagina, but most require taking tissue or skin from another part of your body.

• #37 Müllerian Agenesis: Room for Improvement in Care, Counseling – Research Horizons

  https://scienceblog.cincinnatichildrens.org/mullerian-agenesis-room-for-improvement-in-care-counseling/

  Müllerian agenesis, also known as Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, is a congenital condition that results in underdevelopment of the uterus, cervix and upper two-thirds of the vagina. MRKH affects 1 in 5,000 individuals assigned female sex at birth. This condition results in infertility and can have a significant psychosocial impact. The condition also results in a shortened vaginal canal. Individuals with MRKH are often diagnosed by and seek care from gynecologists. This care can include lengthening of the vaginal canal through dilation and surgery when indicated. […] Overall, 616 individuals with Müllerian agenesis from 40 countries responded to an in-depth survey about their experiences. Of the respondents, 54% received one or more vaginal lengthening treatments. The most common treatments were dilator use (72%), coital dilation (34%) and surgery (39%). Notably, 46% of the respondents reported seeking no vaginal lengthening treatment. This varied by geography, with 59% of respondents in North America and Europe reporting treatments compared to 16% among women from Africa, Asia and South America. Shared themes showed both positive and challenging aspects of vaginal lengthening including difficult physical symptoms, practical and psychosocial challenges, intimate relationships and sexual satisfaction, and impact of experiences with healthcare providers.

• #38

  https://journals.lww.com/jhrs/fulltext/2019/12010/our_experience_in_the_management_of_vaginal.11.aspx

  Pre-operative counseling helps in better postoperative compliance of patient and their relatives in terms of understanding the postoperative results and psychosocial impact on the patient. […] The psychosocial impact, difficulty in marriage issues, and sexual satisfaction of the patient and partner are some of the challenges faced by this population and her family to survive in the Indian Society. […] Here, the authors used it as aid during diagnostic radiology for better interpretation of the surgical anatomy of the transverse vaginal septum which helped in planning the reconstructive surgery.

• #39 Vaginal Agenesis – Giggles – Giggles

  http://giggles.co.in/departments/vaginal-agenesis/

  Vaginal Agenesis is a rare congenital defect that affects the lives of many women around the world. Women with Vaginal Agenesis often struggle with feelings of shame and inadequacy and may face significant barriers in relationships and intimacy. […] We provide treatment as well as counselling for women suffering from Vaginal Agenesis because we understand that these women are warriors, and with the right support, they can go on to live normal lives. […] Treatment options are available for Vaginal Agenesis. The main forms of treatment include: Self dilation, Surgical intervention. […] At Giggles Hospital, our team of specialists strives to offer world-class treatment. We ensure that our patients get only the best and most accurate diagnosis and effective treatment options to manage their condition. […] Complications associated with Vaginal Agenesis include kidney and urinary tract problems, congenital heart conditions, difficulty conceiving, and sexual and psychological issues.

• #40 What Is Vaginal Agenesis?

  https://www.virginiacenterforwomen.com/blog/458725-what-is-vaginal-agenesis

  Vaginal agenesis is a rare congenital condition that impacts the development of a babys reproductive system. As a result, a baby girl may be born without certain reproductive organs or a vagina. […] An OBGYN may be the first person to diagnose this condition and they will become a valuable part of you or your daughters treatment plan. […] Despite this genetic abnormality, the patient is still considered female. […] Of course, this can be confusing and a lot to process, which is why an OBGYN can be a great doctor and specialist to turn to for help, support, and care during this time. […] Your OBGYN will take an active role in providing you and your teen with any needed care, treatment, and support. Your gynecologist can address your concerns, answer your questions and be an advocate for your health.

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