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Lower urinary tract symptoms in women with vaginal agenesis


Introduction and hypothesis

Congenital vaginal aplasia is a condition with devastating implications for fertility and sexuality. However, little is known on whether urinary symptomatology is more common prior and following vaginal lengthening procedures in these women.


We performed a prospective observational study of 19 women with vaginal agenesis before and after vaginal dilation treatment or a laparoscopic Vecchietti procedure. All women completed the ICIQ FLUTS questionnaire before and after treatment in order to assess incidence and changes in urinary symptomatology.


Urinary symptoms were present in 53% of women prior to treatment. The majority of bladder symptoms were not significantly altered by treatment, except for incomplete bladder emptying. Women following the Vecchietti procedure had increased urinary hesitancy and a poorer steam compared with those completing dilation treatment. The longer the vaginal length, the greater the urinary frequency.


Women with vaginal agenesis had significant levels of urinary symptoms and to our knowledge this has not been reported before. The majority of symptoms were not altered by treatment.

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  1. 1.

    Ismail IS, Cutner AS, Creighton SM (2006) Laparoscopic vaginoplasty: alternative techniques in vaginal reconstruction. BJOG 113:340–343

    PubMed  Article  CAS  Google Scholar 

  2. 2.

    Bianchi M, Sola V, Ricci P, Pomes C (2007) Late postoperative urinary stress incontinence after a laparoscopic-assisted Vecchietti procedure for neovagina creation in a patient with Rokitansky syndrome: successful treatment with the TVT-O technique. J Minim Invasive Gynecol 14:116–118

    PubMed  Article  Google Scholar 

  3. 3.

    Ismail-Pratt IS, Bikoo M, Liao LM, Conway GS, Creighton SM (2007) Normalization of the vagina by dilator treatment alone in Complete Androgen Insensitivity Syndrome and Mayer-Rokitansky-Kuster-Hauser Syndrome. Hum Reprod 22:2020–2024

    PubMed  Article  Google Scholar 

  4. 4.

    Fedele L, Bianchi S, Tozzi L, Borruto F, Vignali M (1996) A new laparoscopic procedure for creation of a neovagina in Mayer-Rokitansky-Kuster-Hauser syndrome. Fertil Steril 66:854–857

    PubMed  CAS  Google Scholar 

  5. 5.

    Jackson S, Donovan J, Brookes S, Eckford S, Swithinbank L, Abrams P (1996) The Bristol female lower urinary tract symptoms questionnaire: development and psychometric testing. Br J Urol 77:805–812

    PubMed  Article  CAS  Google Scholar 

  6. 6.

    Liao LM, Conway GS, Ismail-Pratt I, Bikoo M, Creighton SM (2011) Emotional and sexual wellness and quality of life in women with Rokitansky syndrome. Am J Obstet Gynecol 205:117.e1–117.e6

    Article  Google Scholar 

  7. 7.

    Watson AJ, Currie I, Curran S, Jarvis GJ (2000) A prospective study examining the association between the symptoms of anxiety and depression and severity of urinary incontinence. Eur J Obstet Gynecol Reprod Biol 88:7–9

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Kimberley N, Hutson JM, Southwell BR, Grover SR (2011) Well-being and sexual function outcomes in women with vaginal agenesis. Fertil Steril 95:238–241

    PubMed  Article  Google Scholar 

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Details of ethics approval

Ethics approval was received by the joint UCL/UCLH committee on human research (REC Ref: 07/H0714/121).



Conflicts of interest

Alfred Cutner is a consultant at Surgical Innovation and American Medical Systems and is the Vice Chair of the British Society of Urogynaecology

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Corresponding author

Correspondence to Sarah M. Creighton.

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Michala, L., Strawbridge, L., Bikoo, M. et al. Lower urinary tract symptoms in women with vaginal agenesis. Int Urogynecol J 24, 425–429 (2013).

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  • MRKH syndrome
  • Vaginal dilation
  • Laparoscopic Vecchietti
  • Urinary symptoms