Long Term Findings Concerning the Mental and Physical Condition, Quality of Life and Sexuality after Laparoscopically Assisted Creation of a Neovagina (Modified Vecchietti Technique) in Young MRKHS (Mayer-Rokitansky-Küster-Hauser-Syndrome) Patients.

Katharina Rall,Norbert Schäffeler,Andrina Kölle,Bernadette Schenk,Dorit Schöller,Sara Y Brucker,Birgitt Schönfisch

doi:10.3390/jcm10061269

Katharina Rall, Norbert Schäffeler + Show 5 more

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https://doi.org/10.3390/jcm10061269

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Abstract

The Mayer-Rokitansky-Küster-Hauser-syndrome (MRKHS) is characterized by a congenital uterine and vaginal aplasia. A large body of literature reports that a diagnosis of MRKHS has a variety of psychological effects on patients and doubts about female identity. The aim of the underlying study was to detect the patient-reported physical and mental health and sexual function before and after laparoscopically assisted creation of a neovagina. 160 women with MRKHS who underwent this type of surgery between September 2009 and December 2015 were invited to complete the questionnaires. Packages consisting of six questionnaires were handed out before surgery, six and 12 months after surgery. Data from 82 patients could be included in the study. Patients had a mean age of 19.9 years at inclusion in the study. We detected an impairment of the health-related mental quality of life. There was no higher risk for psychological disorders. MRKHS patients show similar self-acceptance and normal body image compared to the general population. The sexual function is limited before surgery and normalizes after surgery. Useful factors for coping with the disease are an interdisciplinary approach in diagnostics and treatment, psychosocial adaptation as well as a supportive social environment.

Highlights

The Mayer-Rokitansky-Küster-Hauser-syndrome (MRKHS) is characterized by the congenital absence of a functioning uterus and the upper 2/3 of the vagina [1]
Using the Scale for the detection of self- acceptance (SESA) questionnaire, nearly 70% of the MRKHS patients did not need a differentiated examination in order to exclude a depressive disorder at any of the timepoints and compared to a depressive reference sample our patients showed significant better scores
With the SESA questionnaire we focused on the course of time and its effect on the self-esteem

Summary

Introduction

The Mayer-Rokitansky-Küster-Hauser-syndrome (MRKHS) is characterized by the congenital absence of a functioning uterus and the upper 2/3 of the vagina [1]. The diagnosis often falls into a phase of life that is characterized by both physical and psychosocial changes and crises, and essentially shaped by the development of female identity and sexuality [6,7,8]. In this period of life with the transition from childhood to adulthood, the diagnosis of MRKHS presents a great emotional and mental burden for patients, in particular due to the infertility and the lack of cohabitation ability [6]. Dilation can be performed surgically with Vecchietti’s procedure [13]

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