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

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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 8th procedure, with an increase after the completion of 20 procedures. In group 2, the dynamics of pain intensity significantly decreased in comparison with the 1st 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.

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About the authors

Diana A. Kruglyak

Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center

Author for correspondence.
Email: diana.kruglyak@yandex.ru
ORCID iD: 0000-0002-1367-2530
SPIN-code: 9668-3178
Russian Federation, 4, Oparina street, Moscow, 117997

Nataliya A. Buralkina

Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center

Email: diana.kruglyak@yandex.ru

Dr. Sci. (Med.)

Russian Federation, 4, Oparina street, Moscow, 117997

Marina V. Ipatova

Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center

Email: diana.kruglyak@yandex.ru
ORCID iD: 0000-0003-2094-8571
SPIN-code: 1006-6969

Dr. Sci. (Med.)

Russian Federation, 4, Oparina street, Moscow, 117997

Elena V. Uvarovа

Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center; The First Sechenov Moscow State Medical University (Sechenov University)

Email: diana.kruglyak@yandex.ru
ORCID iD: 0000-0002-3105-5640
SPIN-code: 9534-6570

Corr. Member of Russian Academy of Sciences, Dr. Sci. (Med.), Professor

Russian Federation, 4, Oparina street, Moscow, 117997; Moscow

Tatyana B. Malanova

Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center

Email: diana.kruglyak@yandex.ru
SPIN-code: 9846-9433

Cand. Sci. (Med.)

Russian Federation, 4, Oparina street, Moscow, 117997

Zalina K. Batyrova

Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center

Email: diana.kruglyak@yandex.ru
ORCID iD: 0000-0003-4997-6090
SPIN-code: 7226-1949

Cand. Sci. (Med.)

Russian Federation, 4, Oparina street, Moscow, 117997

Zaira K. Kumykova

Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center

Email: diana.kruglyak@yandex.ru
ORCID iD: 0000-0001-7511-1432
SPIN-code: 4346-6183

Cand. Sci. (Med.)

Russian Federation, 4, Oparina street, Moscow, 117997

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