Expansion of Vaginal lining by Nonoperative Gaaduated Dilatation

ABSTRACT

The surgical construction of vagina could certainlty be done by skin grafting or flaps, but it involves hospitalization, discomfort,scarring of donor area and vaginal tract, hygiene problem. The tissues of the vagina are soft and distensible and it is reasonable to assume that these same tissues could be stretched, elongated or dilated with gradual external pressure. So, we performed the expansion of vaginal lining by self designed set of graduated dilators. The patients was a 27-years-old female whose chief complaint is amenorrhea and incapability to engage in sexual intercourse. On physical examination, this patients had a feminine figure with a normal vulva but only a vaginal dimple was observed. The patient was educated to carry out the mechanical dilation of this dimply by pressure 15 minutes twice a day. In the evening, with insertion of a dilator, the patient was asked to sit on a bicycle chair for 10 minutes. After 8 weeks, the overall outcome of vaginoplasty was successful. The vaginal tract was 8 cm in length and the largest vaginal speculum could be passed into vagina. The patient was able to engage in sexual intercourse without lubrication. The progressive dilatation of vaginal lining is non-invasive and probably the simplest way to treat the patients with congential vaginal atresia. So we recommend this method as the first treatment strategy before surgery.