生物医学转化 (Sep 2024)
Clinical application of biological graft vaginoplasty in patients with MRKH Syndrome
Abstract
Objective This study aimed to evaluate the psychological health, quality of life, and sexual function in patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome treated with biological graft vaginoplasty. Methods This study was a single-center prospective study, including 103 patients diagnosed with MRKH syndrome who underwent biological graft vaginoplasty at Peking Union Medical College Hospital between January 2018 and June 2023. Comprehensive phenotypic assessment information from patients' preoperative outpatient visits, postoperative data from their hospitalization and surgery, follow-up information at 3 months and 1 year postoperatively during outpatient visits,and the relevant questionnaires completed at the 1-year follow-up were collected. A total of 83 patients completed the 1-year follow-up and completed relevant questionnaires under informed consent, including the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7)for psychological health assessment, and the Short Form-12 (SF-12) for quality of life evaluation. Results were compared with general population data from the literature. Sexual function was evaluated at the 1-year follow-up,with 49 patients who had been sexually active in the past 4 weeks completing the Female Sexual Function Index(FSFI) questionnaire.The control group consisted of 49 sexually active, age-matched, and healthy females. Results The mean age of patients was 23.39±6.03 years, with an average postoperative follow-up time of 14.42±3.38 months.At the last follow-up, the mean vaginal length was 7.89±1.28 cm, and the mean vaginal width was 2.95±1.06 cm. One-year postoperatively, patients had significantly higher PHQ-9 scores compared to the general population (P=0.03),while GAD-7 scores showed no significant difference (P=0.5).The SF-12 physical component score(PCS)was significantly lower(P=0.002),whereas the mental component score(MCS)was significantly higher(P<0.001)compared to the general population.Sexual function evaluation revealed no significant difference between patients and controls in the total FSFI score and the proportion of individuals meeting the criteria for normal sexual function,but patients scored significantly lower in orgasm(P=0.01)and pain(P=0.01)compared to healthy controls.There were differences in the prevalence of sexual dysfunction,with a significantly lower proportion of patients with vaginal lubrication dysfunction (P<0.001) and a significantly higher proportion of orgasm dysfunction (P=0.009).Pearson correlation analysis showed a significant positive correlation between postoperative time and FSFI scores.Conclusion After biological graft vaginoplasty, MRKH patients report generally satisfactory psychological health,quality of life,and sexual function.
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