Sexual and Pelvic Floor Muscle Function in Patients With Vaginal Agenesis

Importance Vaginal agenesis is a rare condition that is treated with vaginal dilation or surgery. The treatment, however, has a significant effect on the quality of life and sexual function of patients. Objective The objective of this study was to investigate the effects of surgical and vaginal dilation treatment on pelvic floor muscle function, sexual function, and quality of life in women with vaginal agenesis. Study Design Patients with vaginal agenesis treated between October 2020 and December 2024 were enrolled in this prospective cohort study. Participants selected neovaginoplasty (Group 1) or progressive vaginal dilation (Group 2). Pelvic floor and sexual function and quality of life were assessed after 12 months. Results Eleven women participated in the study: 6 in Group 1 and 5 in Group 2. Ten women presented with the 46, XX karyotype and 1 with the 46, XY karyotype. The final mean vaginal length was 8 cm in Group 1 and 5 cm in Group 2 ( P = 0.004); 10 participants reported being sexually active, and sexual function according to the Female Sexual Function Index total score differed significantly between the groups, being higher in Group 1 ( P = 0.047). Pelvic floor muscle function investigated using the Pelvic Floor Sensory and Muscle Function Examination (EFSMAP) did not differ significantly between groups. The quality of life assessed by the Short-Form Health Survey also showed no significant differences between the groups before or after treatment. Conclusion Patients with vaginal agenesis treated with surgery or vaginal dilation presented similar pelvic floor muscle function and quality of life, whereas sexual function and vaginal length were higher in the surgery group.