Development and Use of a Custom-Designed Vaginal Dilator for Post-Surgical Management in a Congenital Adrenal Hyperplasia Patient

We present the open-source development and application of a novel, custom-engineered vaginal dilator for the post-surgical management of vaginal stenosis in a 29-year-old patient with congenital adrenal hyperplasia. This methodology highlights a collaborative approach between surgical teams and biomedical engineers, addressing limitations in traditional dilators by designing patient-specific molds based on MRI measurements. The dilator, made of biocompatible silicone elastomer and created using a simple 3D-printing process, demonstrated superior patient comfort and compliance in this patient. The use of this innovative device could improve surgical outcomes, reduced re-stenosis rates, and enhanced patient quality of life. Additionally, the surgical approach for clitoral reduction is described, emphasizing its complexity and the importance of preserving neurovascular integrity to avoid complications such as pain or sensory loss. The case underscores the importance of tailored interventions, as well as interdisciplinary collaboration and the potential of this for broader application of novel methodologies in similar clinical contexts.