Psychosexual and functional outcomes after creation of a neovagina with laparoscopic Davydov in patients with vaginal agenesis

Objective

To describe sexual function and satisfaction after laparoscopic Davydov vaginoplasty in patients with an absent vagina due to Mayer-Rokitansky-Kuster-Hauser syndrome or androgen insensitivity syndrome compared with a control female population.

Design

A descriptive study of standardized, validated psychosexual and functional outcomes using a self-report questionnaire.

Setting

Two tertiary care hospitals at an academic medical center.

Patient(s)

Six women with Mayer-Rokitansky-Kuster-Hauser syndrome or androgen insensitivity syndrome who underwent laparoscopic Davydov.

Intervention(s)

Patients postoperatively completed a self-report survey of their medical, surgical, and sexual history and the standardized, validated Female Sexual Function Index (FSFI) and select questions from the Golombok Rust Inventory of Sexual Satisfaction (GRISS).

Main Outcome Measure(s)

Total scores and domain scores (desire, arousal, lubrication, orgasm, pain, satisfaction) on the FSFI were compared with a published control population of women. Descriptive results of domain questions on the selected questions of the GRISS were identified.

Result(s)

Six patients, aged 20–52 years, returned the questionnaires. Responses to the modified GRISS are represented by visual frequency of response bar graphs. Compared with the control population, the patients' scores were lower for arousability, lubrication, orgasm, and comfort on the FSFI.

Conclusion(s)

Sexual function appears impaired in these six women who underwent laparoscopic Davydov as assessed by the FSFI. This may reflect characteristics of the patient population, as well as the inclusion of all patients' data even if they did not attempt vaginal intercourse in the previous month.

Key Words: Müllerian agenesis, Mayer-Rokitansky-Kuster-Hauser syndrome, androgen insensitivity syndrome, Davydov, sexual function, vaginoplasty, surgical therapy, neovagina