Dilation as treatment for vaginal agenesis and hypoplasia: a pilot exploration of benefits and barriers as perceived by patients.

Reconstructive surgery has been the traditional treatment for the short vagina. Recently vaginal dilation has been recommended due to its low morbidity. Small retrospective studies have reported success rates of up to 80% but include neither clear definitions of "success" nor exploration of factors associated with compliance and outcome. The first 10 women prescribed vaginal dilation treatment at a specialist gynaecological clinic during the study period were interviewed and asked to complete the Multi-dimensional Sexuality Questionnaire (MSQ), with an assessment of perceived vaginal characteristics. The participants scored lower scores on sexual esteem, sexual assertiveness and sexual satisfaction and higher scores in sexual anxiety, sexual depression and fear of sexual relationships in comparison with the standardisation sample. Dilator treatment must be subject to the same scrutiny as any intervention. Vaginal dilation can have a negative emotional impact on women and psychological intervention may be needed to maximise efficacy.