Long-term results after operative correction of vaginal aplasia.

Abstract

We evaluated the long-term results after operative correction of vaginal aplasia with special interest in sexual and psychologic rehabilitation. Forty-four patients who had undergone surgical construction of an artificial vagina took part in follow-up. The operative result was assessed by a gynecologic examination. A structured interview and five questionnaires allowed an evaluation of psychosexual rehabilitation. The measured length of the vagina ranged between 3.5 and 15 cm. Unimpaired sexual intercourse could be ensured in a vagina with a minimum length of > or = 6 cm. The early onset of regular sexual intercourse played an important role for the long-term success of the operation. Patients were considered for an operation if they had a steady partner and hence could guarantee early and regular coitus. This concept was substantiated in our follow-up investigation. The increase in self-confidence thanks to sexual rehabilitation was striking. In a preoperative and postoperative survey 27 of the 44 patients displayed an impressive increase in self-confidence. However, infertility still posed a problem after successful surgical intervention. The overwhelming majority of patients were still depressed about infertility many years after the operation. One way to solve this problem may be adoption. After surgery 82% of patients achieved a functional satisfactory postoperative result combined with overall psychosexual rehabilitation. An intensification of medical and psychologic care after discharge could further improve the long-term results. Special support is needed to solve the problem of infertility.