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What is 'normal' and what are the long-term results of treatments to enlarge or create a vagina?
In all the disorders of sexual or genito-urinary development there is very little published information on the results of vaginal surgery or vaginal dilatation. The studies that have been published often look at surgical results from the surgeons view point and rarely look at the patient's satisfaction with the results, be it cosmetic, sexual or psychological. Vital information on the results of childhood versus adult surgery, and vaginal surgery versus vaginal dilatation, is missing.
This lack of information is hard to understand. How can you advise new patients with these conditions when you don't know the results of your treatment and those other clinicians offer?
By surveying as many people as possible with these conditions we hope to start collecting this information in an un-biased way. Our hope is that we will begin to answer the questions below and begin a new era of open, evidence-based management, where patients will be fully informed before making decisions on their own treatment.
1. A questionnaire that details diagnosis, any past surgery, treatments used to create/enlarge the vagina, reasons for success/failure of these treatments and psychosexual function. The questionnaire is anonymous. The sexual functioning part of the questionnaire will be given a numerical score and then destroyed. People are asked to add their details at the end so that we can confirm details from the various hospital notes. This is essential if other clinicians are going to accept our results as properly validated.
2. A gentle vaginal examination to document:
This is a vital part of the study and would be performed by myself (Cathy Minto) or Miss Sarah Creighton, both experienced gynaecologists. The vaginal dimensions (width at the top, width at the introitus, and non-stretched depth) would be assessed using various Amielle vaginal dilators. People responding to the questionnaire are asked to come to London (return rail expenses paid!) for this examination at the combined gynaecology/endocrinology clinic that we run at University College Hospital.
3. A thorough review of hospital case notes in those responders to the questionnaire that give me permission. I would like to document:
Cathy Minto: I am a doctor, about half way through my training to become a consultant in obstetrics and gynaecology. I am currently employed by University College Hospital, London, as a clinical research fellow, in the Department of Obstetrics and Gynaecology. I will spend the next two years working on this research project.
Miss Sarah Creighton: Consultant Obstetrician and Gynaecologist at University College London Hospital Trust (includes the Middlesex hospital) with experience in paediatric gynaecology.
Miss Melanie Davies: Consultant Obstetrician and Gynaecologist at University College London Hospital Trust, with experience in reproductive medicine.
Dr Gerard Conway: Consultant Endocrinologist at University College London Hospital Trust, with experience in reproductive endocrinology.
If you would be interested in helping with this study, please contact me, Cathy Minto at:
Department of Obstetrics & Gynaecology,
University College London,
86-96 Chenies Mews,
London WC1E 6HX
Tel: 0171 209 6652 (direct line)