Sexual Life of Women With Rokitansky Syndrome After Laparoscopic Vecchietti’s Vaginoplasty

Abstract

Adequate anatomy and physiology functions of genitalia are fundamental pre-requisites for sexual well-being and reproduction. Mayer-Rokitansky-Küster-Hauser Syndrome (MRKHS) compromises female sexual life and makes reproduction impossible. The aim of this study is to evaluate the psycho-sexual results of vagina reconstruction in patients with MRKHS using laparoscopic Vecchietti’s technique, to determine their impact on reproductive choices. This study included 42 patients with MRKHS who underwent laparoscopic Vecchietti’s vaginoplasty. Their partners were also interviewed. Forty-five age matched healthy sexual active women as a control group were examined during the same period. A gynecological examination was performed to determine the anatomical outcome. Psycho-sexual functioning was evaluated with the revised Female Sexual Distress Scale-Revised (FSDS-R), the Female Sexual Function Index (FSFI) and semi-structured interview. Genital self-image was evaluated using the Female Genital Self-Image Scale (FGSIS). Average length of neovagina (7.0 ± 9.6 cm) for study group with MRKHS was significantly shorter than that of the control group (9.3 ± 2.5 cm). Sexual function in neovagina women was satisfactory (FSFI score 29 ± 2.7) not significantly different from the control group (P < .05) but they had significantly higher levels of stress (FSDS-R scores 14.5 ± 6.5) and were not satisfied with their genital (FGSIS scores 22.0 ± 2.4) compared to the control group. 95% of patients wish to have their own baby. Surrogate motherhood would be accepted only by 35% of women and 83% of women would think about adoption. Uterus transplantation would be accepted by 90% women and 26% of them consider it as the last option.