Possibilities of physiotherapy in Mayer–Rokitansky–Kuester–Hauser syndrome

Abstract

BACKGROUND: Mayer–Rokitansky–Kuester–Hauser syndrome occurs in 1 of 4000–5000 newborn girls. The first-line treatment of aplasia of the vagina is considered a vaginal dilation. The use of physiotherapy capabilities in the practice of obstetricians and gynecologists is quite widespread and has firmly established itself in clinical practice.

AIMS: To evaluate the effectiveness and tolerability of dilation in combination and without physical effects in the formation of vagina in adolescent girls.

MATERIALS AND METHODS: A prospective cohort study of 64 adolescent girls 15 to 18 y with a first-time diagnosis of vaginal and uterine aplasia was conducted. Their psychophysiological features were analyzed with testing according to the questionnaire well-being, activity, mood (SAN), physical and sexual development, a gynecological examination was performed to determine the depth of the vaginal fossa. Teenage girls were randomized into 2 groups: 1 (n=36) — to create an artificial vagina, with the method of dilation. The second group of patients (n=28) underwent preformed physiotherapy with subsequent dilation. All the girls daily made a graph of the increase in the length of the vagina and determined the intensity of pain using a visual-analog scale (VAS). After the treatment was completed, the patients were re-tested according to the SAN method.

RESULTS: A significant increase in the length of the neovagal space was noted in the group of complex treatment with physiotherapy already at the 8^th procedure, with an increase after the completion of 20 procedures. In group 2, the dynamics of pain intensity significantly decreased in comparison with the 1^st group. The psychological status of the patients according to the SAN before the start of treatment was characterized by an unfavorable state.

CONCLUSION: Conducting course procedures of complex dilation with the use of heat-magneto-vibration in girls with vaginal aplasia has a significant reduction in pain and allowed to achieve the required anatomical length in a shorter time compared to monomethodics.

Keywords

vaginal aplasia / vaginal dilation / vaginal fossa / neovagina / bloodless / heat-magneto-vibration effect

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