Management Outcome in Patients with Acquired Gynaetresia in Ibadan

Abstract

Context: In marriage, great importance is placed on a satisfactory sexual life and child bearing. Whereas companionship is the primary purpose of marriage in many western societies, here in Nigeria procreation is the central issue in marriage. Acquired gynaetresia is commonly associated with infertility in tropical Africa. Objective: To determine the prevalence of acquired gynaetresia in our gynaecological practice and assess the outcome of its management. Study Design: A retrospective analysis of patients presenting with acquired gynaetresia between January 1984 and December 1998, at the University College Hospital, Ibadan. Main Outcome Measures: The relative proportion of cases of acquired gynaetresia compared to the total number of the gynaecological cases seen during the study period. The definitive treatment modalities employed, treatment outcome and the complications encountered. Result: Acquired gynaetresia accounted for 0.52% of all major gynaecological admissions during the study period. The patients' ages ranged from 5 to 54 years. Chemical vaginitis from pessary insertion into the vagina was the commonest aetiological factor, followed by complications of female genital mutilation. The 2-stage vaginoplasty (Mcindoe's Operation) was the most commonly employed procedure to restore vaginal patency. Post-operative morbidity was low. Pregnancy was recorded in 5 patients during the follow-up period. Conclusion: Acquired gynaetresia contributes significantly to reproductive health morbidity in the developing world, often resulting from ignorance and harmful traditional practices. Public health education and wide spread enlightenment of the populace to eliminate the preventable causes is suggested, to reduce the burden of acquired gynaetresia in contemporary gynaecological practice. (Tropical Journal of Obstetrics and Gynaecology, 2001, 18(1): 12-15)