Sexological and Psychological Problems Affecting Women with Congenital Malformations of Genital Organs – Clinic Observation Seksuologiczne I Psychologiczne Problemy U Pacjentek Z Wrodzonymi Wadami Rozwojowymi Narządów Płciowych – Obserwacje Kliniczne

Introduction. The data on psychological status of patients with congenital defects of urogenital tract are very scarce, yet it was confi rmed that reactions to the information about diagnosed anomaly and then patients’ attitudes toward treatment vary with a kind of malformation, patient’s age and personality. Aim of the study. The aim of the study was to analyze the correlation between the severity of malformation of urogenital organs and psychological status of the patient. Material and methods. 102 female patients with congenital anomalies of the genital tract, hospitalized in Gynecogical Clinic in the years 1983–2000, were analyzed. All presented patients needed multidirectional diagnostics and treatment. Diagnosis was made based on clinical examination, including psycho-sexological consultation. Malformations diagnosed in the patients were divided into 5 groups. Results. Malformations diagnosed in the patients were divided into the following groups: Group I: Congenital atresias of the female genital tract (gynatresias) – imperforate hymen; 34 patients; all treated effectively by incision of hymen (hymenectomy). Group II: Vaginal and uterine septa; 11 patients; these malformations develop in the fetal period as a consequence of inappropriate degeneration of paramesonephric ducts’ apposed walls. Group III: Duplications of the female genital organs – double uterus and vagina. 13 patients, these malformations arise from complete failure of unifi cation of the paramesonephric ducts in parts that normally join to form uterus and vagina. Group IV: Rudimentary genital tract and genital tract hypoplasia; 15 patients, these malformations follow an incomplete development of paramesonephric Müllerian ducts. Group V: Congenital absence of the vagina and uterus (aplasia) – the Rokitansky syndrome; 29 patients. Awareness of severe malformations, especially those resulting with inability to give birth, had strong impact on patient’s psyche. Conclusions. It is essential to point, that clinical management of patients with malformations of the genital tract, particularly in Rokitansky syndrome, must include psychological counseling. Medical professionals should be aware of psychosocial effects of these disorders.