Background: Mayer-Rokitansky-Kuster-Hauser (MRKH) is one of the causes of primary amenorrhea. It is characterized by the absence of uterus and upper two-third vagina. Apart from being infertile, these patients may have psychological problems and associated anomalies, which need to be addressed.
Objective: To address the management of fertility and sexual function in these patients.
Materials and methods: This has been a retrospective study conducted in the Department of Obstetrics and Gynecology, at a tertiary health care center in Ahmedabad from April 2012 to December 2015. Patients who were diagnosed with uterovaginal agenesis on sonography as a workup for primary amenorrhea were included. Other Müllerian anomalies were excluded.
Results: There were seven patients with MRKH, out of which three patients had Müllerian agenesis with no other associated anomaly, two patients had associated renal anomaly, and one patient had anal anomaly and malrotated right single kidney with absent uterus (cloaca). Six patients underwent McIndoe vaginoplasty and one underwent laparoscopic vaginoplasty. None of them had graft rejection; however, one patient had rectovaginal fistula, which was presented on 10th postoperative day. On follow-up, adequate vaginal length was seen in patients who underwent McIndoe vaginoplasty as compared with laparoscopic vaginoplasty.
Conclusion: Though these patients do not have a uterus and vagina, there is still hope that they can have good sexual life and can have their own genetic offspring.
Keywords: Cloaca, Fistula, Mayer-Rokitansky-Kuster-Hauser, Renal anomalies, Vaginoplasty.
How to cite this article: Mishra VV, Saini SR, Nanda S, Shah K, Aggarwal R, Gandhi K. Management of Fertility and Sexual Function in Cases of Mayer-Rokitansky-Kuster-Hauser: An Overview. J South Asian Feder Obst Gynae 2017;9(2):79-83.
Source of support: Nil
Conflict of interest: None
Date of received: 10 December 2016
Date of acceptance: 2 January 2017
Date of publication: March 2017