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Gilfillan R, Carter P. Issues of identity, perceptions and isolation: An interpretative phenomenological analysis of women's experience of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. J Health Psychol 2024; 29:200-212. [PMID: 37771134 DOI: 10.1177/13591053231199253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
The objective of this study was to explore the personal experience of women with MRKH, a rare condition characterised by congenital abnormalities of the genital tract. There are very few qualitative studies into the lived experiences of women with MRKH. Interviews were conducted with 13 women with MRKH and analysed using interpretative phenomenological analysis. Four superordinate themes are discovered: maintaining a viable female identity; acceptance and coping; normality, secrecy and shame and the isolating impact of a lack of knowledge amongst the medical profession. This study also suggests that societal ideals of a 'normal woman' are influencing how MRKH impacts on the self-experienced psychological health. It is suggested that the psychological wellbeing of women with MRKH could be improved with continued multidisciplinary support beyond the initial diagnosis and alongside any vaginal correction.
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HadaviBavili P, İlçioğlu K, Hamlacı Başkaya Y. Evaluation of Sexual Function Outcomes in Patients with Rokitansky Syndrome: A Systematic Review and Meta-analysis. J Minim Invasive Gynecol 2023; 30:705-715. [PMID: 37271411 DOI: 10.1016/j.jmig.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE In patients with Rokitansky syndrome, vaginal agenesis can be treated using various surgical techniques, and various factors can affect each surgery outcome in the long term. This meta-analysis aimed to evaluate sexual function outcomes in patients with Rokitansky syndrome after various surgery techniques. DATA SOURCES Searches were conducted in Google Scholar, PubMed, Cochrane database, ScienceDirect, Web of Science, and ClinicalTrials.gov. Systematic searches were conducted on studies published until November 2022 (CRD42022370735). METHODS OF STUDY SELECTION During the first stage of database scanning and reference check, 1820 results were identified, and an evaluation of the total 10 studies was finally conducted. The inclusion criteria involved selecting randomized controlled trials that focused on assessing sexual function after surgical treatment in patients of all ages with Rokitansky syndrome. TABULATION, INTEGRATION, AND RESULTS EndNote version 20 software was used to organize and identify duplicate articles through screening. The Joanna Briggs Institute's critical appraisal tool was used to evaluate each study's quality for bias potential. The results showed that the total scores of female sexual functions in patients with Rokitansky syndrome after vaginoplasty were significantly lower than in healthy women (standardized mean difference, -0.233; p <.05; range, -0.376 to -0.090). The 6-domain analysis of the Female Sexual Function Index questionnaire revealed that lubrication (p <.05) and satisfaction (p <.05) were significantly lower in patients undergoing vaginoplasty. CONCLUSION All surgical techniques to create a neovagina for patients with Rokitansky syndrome have successfully affected the sexual function outcomes. Considering all other factors affecting sexual function outcomes in the long term, more quantitative and qualitative studies are needed to assess sexual satisfaction in patients treated with surgical techniques.
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Affiliation(s)
- Parisa HadaviBavili
- Faculty of Health Sciences, Department of Midwifery (HadaviBavili and Dr. Hamlacı Başkaya), Sakarya University, Sakarya, Türkiye; Sakarya University, Institute of Health Science, Department of Midwifery, Sakarya, Türkiye.
| | - Kevser İlçioğlu
- Faculty of Health Sciences, Department of Nursing/ Obstetrics and Gynaecology Nursing (Dr. İlçioğlu), Sakarya University, Sakarya, Türkiye
| | - Yasemin Hamlacı Başkaya
- Faculty of Health Sciences, Department of Midwifery (HadaviBavili and Dr. Hamlacı Başkaya), Sakarya University, Sakarya, Türkiye
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Reber N, De Clercq E. Enduring uncertainties. Medical accounts on caring for young people with variations of sex characteristics. DIALOGUES IN HEALTH 2022; 1:100014. [PMID: 38515880 PMCID: PMC10953950 DOI: 10.1016/j.dialog.2022.100014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/05/2022] [Accepted: 05/10/2022] [Indexed: 03/23/2024]
Abstract
Objectives The diagnosis of intersex or variations of sex characteristics (VSC) often has a big impact on families who fear social stigmatization. Research has shown that intersex populations often experience important health disparities and that poor mental health and daily function are common among youth with VSC. The present study aimed to explore what healthcare professionals of adolescents and young adults (AYA) with VSC find important in terms of care to this group of patients. Methods Semi-structured interviews were conducted with Swiss healthcare providers involved in the care of youth born with an intersex variation. The qualitative data were analyzed using reflexive thematic analysis. Results Analysis resulted in six major themes: (1) With regard to patients' and families lived experiences, interviewees reported that fertility was as a major issue for parents but not for intersex youth as they were said to live in the moment. (2) Respondents considered various forms of psycho-social care (professional support, peer support and informal support from family and friends) to be of fundamental importance for their patients, but many of them seemed critical about support from advocacy groups and activists. All healthcare providers reported significant gaps in (3) the transition process and (4) the establishment of multidisciplinary care teams due to structural, provider- and patient-related barriers. (5) Participants were in favor of a more holistic and patient-centred care approach and (6) were critical about the medicalized use of DSD (disorder of sex development) with patients and families. Conclusion These findings suggest that although clinicians work hard to implement a holistic approach to care, their intentions are often undercut by a desire to hold a position of medical control. Healthcare professionals need to come to see medical uncertainty not only as a threat but also as an opportunity.
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Affiliation(s)
- Nina Reber
- University of Basel, Institute for Biomedical Ethics, Bernoullistrasse 28, 4056 Basel, Switzerland (CH)
| | - Eva De Clercq
- University of Basel, Institute for Biomedical Ethics, Bernoullistrasse 28, 4056 Basel, Switzerland (CH)
- University of Zürich, Institute of Biomedical Ethics and History of Medicine, Winterthurerstrasse 30, 8006 Zürich, Switzerland (CH)
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De Clercq E, Starke G, Rost M. "Waking up" the sleeping metaphor of normality in connection to intersex or DSD: a scoping review of medical literature. HISTORY AND PHILOSOPHY OF THE LIFE SCIENCES 2022; 44:50. [PMID: 36282442 PMCID: PMC9596528 DOI: 10.1007/s40656-022-00533-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 08/31/2022] [Indexed: 06/16/2023]
Abstract
The aim of the study is to encourage a critical debate on the use of normality in the medical literature on DSD or intersex. For this purpose, a scoping review was conducted to identify and map the various ways in which "normal" is used in the medical literature on DSD between 2016 and 2020. We identified 75 studies, many of which were case studies highlighting rare cases of DSD, others, mainly retrospective observational studies, focused on improving diagnosis or treatment. The most common use of the adjective normal was in association with phenotypic sex. Overall, appearance was the most commonly cited criteria to evaluate the normality of sex organs. More than 1/3 of the studies included also medical photographs of sex organs. This persistent use of normality in reference to phenotypic sex is worrisome given the long-term medicalization of intersex bodies in the name of a "normal" appearance or leading a "normal" life. Healthcare professionals should be more careful about the ethical implications of using photographs in publications given that many intersex persons describe their experience with medical photography as dehumanizing.
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Affiliation(s)
- Eva De Clercq
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland
- Institute of Biomedical Ethics and History of Medicine, University of Zürich, Winterthurerstrasse 30, 8006 Zurich, Switzerland
| | - Georg Starke
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland
- College of Humanities, École Polytechnique Fédérale de Lausanne, Rte Cantonale, 1015 Lausanne, Switzerland
| | - Michael Rost
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland
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Lucchetti MC, Tassi A. First-Line Therapy for Vaginal Atresia. Conservative Treatment vs Surgical Techniques: Quandaries Looking at Numbers. J Pediatr Adolesc Gynecol 2022; 35:426-428. [PMID: 35842237 DOI: 10.1016/j.jpag.2022.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 01/13/2022] [Accepted: 01/23/2022] [Indexed: 01/08/2023]
Abstract
Although it has been clearly stated that vaginal dilation must be considered the first-line treatment for clinical conditions characterized by an absent or hypoplastic vagina, mainly Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, a great number of scientific papers on surgical vaginal reconstructions are reported every year. This wide variety of surgical techniques (more than 10) are recognized and performed worldwide, making it difficult to compare results and define an evidence-based approach. Standardized treatment should be considered even more important in the pediatric and adolescent population for the implications offered by the uterus transplantation scenario.
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Affiliation(s)
- Maria Chiara Lucchetti
- Andrological Surgery, Pediatric and Adolescent Gynecology Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Alice Tassi
- Clinic of Obstetrics and Gynecology, University Hospital of Udine, Udine, Italy
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Vosoughi N, Maasoumi R, Haeri Mehrizi AA, Ghanbari Z. The Effect of Psychosexual Education on Promoting Sexual Function, Genital Self-Image, and Sexual Distress among Women with Rokitansky Syndrome: A Randomized Controlled Clinical Trial. J Pediatr Adolesc Gynecol 2022; 35:73-81. [PMID: 34271197 DOI: 10.1016/j.jpag.2021.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/13/2021] [Accepted: 06/29/2021] [Indexed: 01/13/2023]
Abstract
STUDY OBJECTIVE To assess the effectiveness of psychosexual education on promoting sexual function and genital self-image and reducing sexual distress through e-learning among women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. DESIGN Randomized controlled trial. SETTING Imam Khomeini Hospital "Pelvic Floor Clinic" in Tehran. PARTICIPANTS Thirty-eight 15- to 49-year-old women with MRKH syndrome who had undergone surgical or nonsurgical vaginal reconstruction techniques more than 6 months before the intervention were assigned to 2 parallel intervention and control groups of 19 each. INTERVENTIONS Psychosexual education was delivered through e-learning for the intervention group over an 8-week period, with no limitations of time and space. Sexual function, genital self-image, and sexual distress were evaluated at baseline, and at 4 and 8 weeks after the intervention. MAIN OUTCOME MEASURES The data collection tools included the Persian version of the Female Sexual Function Index, Female Genital Self-Image Scale, and the Revised Female Sexual Distress Scale. RESULTS The between group mean differences of sexual function, genital self-image, and sexual distress after 4 weeks (-1.2 [95% CI, -2.1 to -0.1], P = .025; -1.9 [95% CI, -2.9 to -0.9], P < .001; 4.2 [95% CI, 2.0-6.4], P < .001, respectively), as well as after 8 weeks (-1.8 [95% CI, -3.1 to -0.5], P = .009; -3.0 [95% CI, -4.5 to -1.5], P < .001; 6.7, 95% CI, 3.9-9.6], P <0.001, respectively) after baseline were significant. CONCLUSION Psychosexual education improved sexual function and genital self-image and reduced sexual distress in women with MRKH syndrome. Therefore, using this approach, we can raise individuals' sexual knowledge and skills and correct their sexual beliefs and attitudes.
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Affiliation(s)
- Nafiseh Vosoughi
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Raziyeh Maasoumi
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran; Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ali Asghar Haeri Mehrizi
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Zinat Ghanbari
- Department of Obstetrics and Gynecology, Vali-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Young Voices: Sexual Health and Transition Care Needs in Adolescents with Intersex/Differences of Sex Development-A Pilot Study. J Pediatr Adolesc Gynecol 2021; 34:176-189.e2. [PMID: 33181339 DOI: 10.1016/j.jpag.2020.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/07/2020] [Accepted: 11/02/2020] [Indexed: 11/20/2022]
Abstract
STUDY OBJECTIVE To determine the sexual health and well-being needs of current generations of youth with intersex/Differences of Sex Development (DSD) during transition from pediatric to adult health care. DESIGN Qualitative narrative analyses, quantitative descriptives, and questionnaires. SETTING Peer support networks and outpatient clinics. PARTICIPANTS Eighteen adolescents aged 16-21 years with intersex/DSD. INTERVENTIONS Semi-structured interviews and/or survey. MAIN OUTCOME MEASURES Youths learning about bodily differences, their sexual experiences and motives (eg, agency, pleasure), body image, sexual communication inside and outside of health care, and perceived gaps between current and ideal transitional care. Quantitative and qualitative content of the surveys and interviews were analyzed to identify key topics. RESULTS We found that (1) there is a need for open-minded perceptions of health care providers about what it means to have a sex variation: (2) there is a need for continued support and information about lived realities relating to the diagnosis and treatments as well as experiential aspects of sexuality: and (3) there are communication obstacles with providers in a multidisciplinary team setting as well as with parents. CONCLUSION A user-centered care perspective for adolescents with sex variations includes their stories and feedback toward service improvement. This pilot study shows that adolescents want to be more involved in their sexual health care in ways that connect to their specific questions. Their desire for information increases as they grow older, and underlines the most essential lesson that health care providers can bring their patients about their bodies: how to care for, respect, and enjoy them.
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Weijenborg PTM, Kluivers KB, Dessens AB, Kate-Booij MJ, Both S. Sexual functioning, sexual esteem, genital self-image and psychological and relational functioning in women with Mayer-Rokitansky-Küster-Hauser syndrome: a case-control study. Hum Reprod 2020; 34:1661-1673. [PMID: 31418785 DOI: 10.1093/humrep/dez130] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 06/19/2019] [Indexed: 01/08/2023] Open
Abstract
STUDY QUESTION Do sexual functioning, sexual esteem, genital self-image and psychological and relational functioning in women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome differ from a comparison group of women without the condition? SUMMARY ANSWER In comparison to controls, women with MRKH with a non-surgically or surgically created neovagina did not differ in psychological and relational functioning but reported lower sexual esteem and more negative genital self-image, intercourse-related pain, clinically relevant sexual distress and sexual dysfunction, with sexual esteem levels strongly associated with sexual distress and sexual dysfunction. WHAT IS KNOWN ALREADY Studies on sexual functioning measured with standardized questionnaires in women with MRKH syndrome compared with women without the condition have yielded contradictory results. Factors associated with sexual functioning in this patient population have rarely been investigated. STUDY DESIGN, SIZE, DURATION Between November 2015 and May 2017, 54 women with MRKH syndrome with a neovagina and 79 age-matched healthy women without the condition were enrolled in this case-control study. PARTICIPANTS/MATERIALS, SETTING, METHODS All participants had to be at least 18-years old and had to live in a steady heterosexual relationship. Women with MRKH syndrome were asked to participate by their (former) gynecologists at three university hospitals and by MRKH peer support group. Controls were recruited via advertisement in local newspapers and social media. Standardized questionnaires were administered to assess sexual functioning, sexual esteem, genital self-image and psychological and relational functioning. MAIN RESULTS AND THE ROLE OF CHANCE Women with MRKH syndrome with a surgically or non-surgically created neovagina reported significantly more pain during intercourse (P < 0.05, d = 0.5), but did not differ in overall sexual functioning from control women. More women with MRKH syndrome reported clinically relevant sexuality-related distress (P < 0.05, odds ratio (OR): 2.756, 95% CI 1.219-6.232) and suffered a sexual dysfunction (P < 0.05, OR: 2.654, 95% CI: 1.088-6.471) in comparison with controls. MRKH women scored significantly lower on the sexual esteem scale (SES) (P < 0.01, d = 0.5) and the female genital self-image scale (FGSIS) (P < 0.01, d = 0.6) than controls. No significant differences were found between the two groups regarding psychological distress, anxiety and depression, global self-esteem and relational dissatisfaction. Sexual esteem was significantly associated with the presence of clinically relevant sexual distress (ß = 0.455, P = 0.001) and suffering a sexual dysfunction (ß = 0.554, P = 0.001) and explained, respectively, 40% and 28% of the variance. LIMITATIONS, REASONS FOR CAUTION Given the nature of the study focusing on sexual functioning, a potential selection bias cannot be excluded. It is possible that those women with the most severe sexual and/or psychological disturbances did or did not choose to participate in our study. WIDER IMPLICATIONS OF THE FINDINGS The study results add new data to the very limited knowledge about psychosexual functioning of women with MRKH syndrome and are of importance for more adequate counseling and treatment of these women. STUDY FUNDING/COMPETING INTEREST(S) The research was financially supported by the Dutch Scientific Society of Sexology (Nederlandse wetenschappelijke Vereniging Voor Seksuologie). The funding was unrestricted, and there was no involvement in the conduct of the research. There are no conflicts of interest to declare.
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Affiliation(s)
- P T M Weijenborg
- Outpatient Clinic Psychosomatic Gynaecology and Sexology, Department of Gynaecology, Leiden University Medical Centre, Leiden, The Netherlands
| | - K B Kluivers
- Department of Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - A B Dessens
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - M J Kate-Booij
- Department of Gynaecology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - S Both
- Outpatient Clinic Psychosomatic Gynaecology and Sexology, Department of Gynaecology, Leiden University Medical Centre, Leiden, The Netherlands
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Herlin MK, Petersen MB, Brännström M. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: a comprehensive update. Orphanet J Rare Dis 2020; 15:214. [PMID: 32819397 PMCID: PMC7439721 DOI: 10.1186/s13023-020-01491-9] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/05/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, also referred to as Müllerian aplasia, is a congenital disorder characterized by aplasia of the uterus and upper part of the vagina in females with normal secondary sex characteristics and a normal female karyotype (46,XX). MAIN BODY The diagnosis is often made during adolescence following investigations for primary amenorrhea and has an estimated prevalence of 1 in 5000 live female births. MRKH syndrome is classified as type I (isolated uterovaginal aplasia) or type II (associated with extragenital manifestations). Extragenital anomalies typically include renal, skeletal, ear, or cardiac malformations. The etiology of MRKH syndrome still remains elusive, however increasing reports of familial clustering point towards genetic causes and the use of various genomic techniques has allowed the identification of promising recurrent genetic abnormalities in some patients. The psychosexual impact of having MRKH syndrome should not be underestimated and the clinical care foremost involves thorough counselling and support in careful dialogue with the patient. Vaginal agenesis therapy is available for mature patients following therapeutical counselling and education with non-invasive vaginal dilations recommended as first-line therapy or by surgery. MRKH syndrome involves absolute uterine factor infertility and until recently, the only option for the patients to achieve biological motherhood was through gestational surrogacy, which is prohibited in most countries. However, the successful clinical trial of uterus transplantation (UTx) by a Swedish team followed by the first live-birth in September, 2014 in Gothenburg, proofed the first available fertility treatment in MRKH syndrome and UTx is now being performed in other countries around the world allowing women with MRKH syndrome to carry their own child and achieve biological motherhood. CONCLUSION Several advances in research across multiple disciplines have been made in the recent years and this kaleidoscopic review provides a current status of various key aspects in MRKH syndrome and provides perspectives for future research and improved clinical care.
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Affiliation(s)
- Morten Krogh Herlin
- Department of Clinical Genetics, Aalborg University Hospital, Aalborg, Denmark.
- Department of Clinical Genetics, Aarhus University Hospital, Brendstrupgårdsvej 21C, DK-8200, Aarhus N, Denmark.
| | - Michael Bjørn Petersen
- Department of Clinical Genetics, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Mats Brännström
- Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg, Sweden
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Facchin F, Francini F, Ravani S, Restelli E, Gramegna MG, Vercellini P, Aimi G. Psychological impact and health-related quality-of-life outcomes of Mayer-Rokitansky-Küster-Hauser syndrome: A systematic review and narrative synthesis. J Health Psychol 2020; 26:26-39. [PMID: 31960723 DOI: 10.1177/1359105319901308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Mayer-Rokitansky-Küster-Hauser syndrome causes absence or underdevelopment of uterus and vagina, but women's subjective experience remains understudied. This systematic review was conducted to examine the psychological and health-related quality-of-life outcomes of Mayer-Rokitansky-Küster-Hauser syndrome. In total, 22 articles identified through electronic search matched the inclusion criteria and were included in our review. Mayer-Rokitansky-Küster-Hauser syndrome may be associated with psychological symptoms and impaired quality of life, but especially with poor sexual esteem and genital image. Women may experience difficulties managing intimacy and disclosing to partners. Mothers may be perceived as overinvolved, with consequent negative emotions in women with the disease.
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Affiliation(s)
| | | | | | - Elisa Restelli
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Italy
| | | | - Paolo Vercellini
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Italy.,Università degli Studi di Milano, Italy
| | - Giorgio Aimi
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Italy
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Adams Hillard PJ. Dilators for the Vajayjay. J Pediatr Adolesc Gynecol 2019; 32:347-348. [PMID: 31511175 DOI: 10.1016/j.jpag.2019.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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A Research Agenda for Adolescent Menstrual Cycles. J Pediatr Adolesc Gynecol 2019; 32:247-248. [PMID: 31196525 DOI: 10.1016/j.jpag.2019.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Primary Amenorrhea, Aplastic Uterus, and a Functional Vagina: A Rare Case of Mayer-Rokitansky-Küster-Hauser Syndrome. Case Rep Obstet Gynecol 2019; 2019:3409548. [PMID: 31275680 PMCID: PMC6582900 DOI: 10.1155/2019/3409548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 04/09/2019] [Accepted: 05/22/2019] [Indexed: 01/09/2023] Open
Abstract
Background Müllerian agenesis, also known as Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS), a failure of female urogenital development, typically results in a completely stenotic or rudimentary dimple vagina, both of which are generally nonfunctional in adulthood without mechanical dilation or surgical reconstruction. Case A 20-year-old Tanner stage V heterosexual woman with normal sexual function since coitarche presented with a chief complaint of primary amenorrhea. She was found to have aplastic uterine buds, absent endometrium/cervix, normal ovaries, and an unusually well-developed lower vagina, a rare presentation of MRKHS. We discuss mechanisms by which the anomaly may have arisen. Summary & Conclusion This case thus expands the clinical presentation of MRKHS to include a normal appearing vagina with intact sexual function from first sexual encounter, raising interesting questions about the basic underlying embryology.
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