Providers' Experiences with Vaginal Dilator Training for Patients with Vaginal Agenesis

Abstract

Study ObjectiveTo examine providers' experiences with vaginal dilator training for patients with vaginal agenesis. Design and SettingAnonymous electronic survey. ParticipantsMembers of the North American Society for Pediatric and Adolescent Gynecology. Interventions and Main Outcome MeasuresHow providers learn about vaginal dilator training, common techniques, and methods used for patient training, assessment of patient readiness, common patient complaints, issues leading to early discontinuation. ResultsThere were a total of 55 completed survey responses of which 31 respondents (56%) had been in practice for more than 10 years. Forty-nine were gynecologists (89%), 20 had completed a fellowship in pediatric and adolescent gynecology (36%), and 6 were reproductive endocrinologists (11%). Thirty-one respondents had first learned about vaginal dilator training through lectures (56%) whereas only 9 through mentorship and fellowship (16%). According to respondents, the most common issue leading to early discontinuation was lack of patient motivation and readiness (n = 42; 76%). The most common complication was pain or discomfort (n = 45; 82%). More than half of respondents determined dilator therapy was successful when patients reported comfortable sexual intercourse (n = 30; 55%) and 65% (n = 35) did not delineate any restrictions to initiation of sexual intercourse. Most respondents (87%) requested further vaginal dilator training at either a clinical meeting (n = 26; 47%) or with a training video (n = 22; 40%). ConclusionOur study in an experienced cohort of pediatric gynecology providers highlights the need for further research and training on vaginal dilation education.