An update on surgical and non-surgical treatments for vaginal hypoplasia

Abstract

As the medical literature lacks high-quality comparative outcome studies and prospective, longitudinal studies are scarce, no evidence-based treatment guidelines can be provided. However, because of the physically low complication rate and an overall success chance of 75%, vaginal dilation as first choice treatment seems to be justified. Overall, the laparoscopic Vecchietti procedure, becoming more and more available in specialized centres, is considered an appropriate surgical option in patients who are poorly compliant and failed dilation therapy, or for those who do not want to start with vaginal dilation therapy. Future approaches need to raise a wider range of psychosexually oriented questions, elucidate the relationship between vaginal depth and satisfactory outcomes and gain additional experience concerning the format of acceptable and efficient psychological care.

Ambivalent Ambiguity? : A study of how women with 'atypical' sex development make sense of female embodiment

“…It is estimated that about 20% of these individuals are diagnosed when older than 12 years of age (Massa et al, 2005). This condition is, like UVA, included in the DSD label (Lee et al, 2006), but none of my interviewees used DSD, or intersex, when talking about their condition; over surgical alternatives (Callens et al, 2014;Edmonds, 2003;Ismail-Pratt et al, 2007;Liao et al, 2006;Moen, 2000). neither did they relate their condition to such terms or express an awareness about their condition being covered by them.…”

“…The invasiveness of surgical interventions, and the lack of statistically significant differences regarding 'functional' success between non-surgical and surgical methods, are often described as motivating this shift (Callens et al, 2014). However, it has also been noted that success is distinguished in a range of ways in such evaluations (Liao et al, 2006).…”

“…However, it has also been noted that success is distinguished in a range of ways in such evaluations (Liao et al, 2006). In some studies functional success is defined as 'satisfaction with sex', which also includes 'non-genital sex' (Callens et al, 2014), or by using the Female Sexual Functional Index (FSFI), which measures desire, arousal, lubrication, orgasm, satisfaction, and comfort (Kuhn et al, 2013;Morcel et al, 2013). Other studies focus on anatomical success, often defined in terms of the achievement of a vaginal length of 7 cm or more (for an overview, see Callens et al, 2014).…”

“…In some studies functional success is defined as 'satisfaction with sex', which also includes 'non-genital sex' (Callens et al, 2014), or by using the Female Sexual Functional Index (FSFI), which measures desire, arousal, lubrication, orgasm, satisfaction, and comfort (Kuhn et al, 2013;Morcel et al, 2013). Other studies focus on anatomical success, often defined in terms of the achievement of a vaginal length of 7 cm or more (for an overview, see Callens et al, 2014). In general, Lih-Mei Liao et al (2006) asserted, definitions are notably vague; retrospective studies of vaginal dilation have reported a success rate up to 80%, yet rarely do they explore factors such as compliance and outcome.…”

Vaginal Aplasia: Critical Overview of Available Treatment Options

“…The anatomical success rates, defi ned as the achievement of a post-operative vaginal length >6 cm, are reported to be as high as ~99 %, associated with functional success rates of ~95 % [ 6 ]; the mean post-operative neovagina length has been measured ~7.9 cm [ 22 ]. This technique involves the insertion of an acrylic bead in the vaginal dimple that is attached via the peritoneal cavity onto a traction device positioned on the abdominal wall that will gradually pull the vaginal vault upwards.…”