Objective: Dilator therapy has been used successfully for many years to treat vaginal agenesis. Our objective was to show how established physical therapy techniques can be used to augment dilator therapy.
Methods: A 36-year-old woman desiring nonsurgical management of vaginal agenesis was instructed in the use of vaginal dilators by a pelvic-floor physical therapist. Manual stretching of the vaginal tissues was performed during office visits after application of heat and therapeutic ultrasound to the perineum. In addition, the patient's husband was taught how to perform the vaginal stretching at home in conjunction with dilator therapy.
Results: The patient was able to attempt intercourse after 6 weeks of treatment and achieved full penetration by 9 weeks. At the completion of treatment, she scored 31.9 on the Female Sexual Function Index. The patient and her husband were very satisfied with the treatment approach, especially the encouragement and guidance received in physical therapy.
Conclusions: By using established physical therapy techniques in conjunction with dilator therapy, a faster time to intercourse may be achieved with high patient and spouse satisfaction. We recommend the involvement of a physical therapist specializing in the pelvic floor as an adjunct to standard dilator therapy in the treatment of vaginal agenesis.
Combining physical therapy techniques with traditional dilator therapy may lead to improved patient adherence and a faster time to intercourse in patients with vaginal agenesis.
From the Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, Washington, DC.
Reprints: William B. Warner, MD, Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, 6900 Georgia Ave, NW, Washington, DC 20307. E-mail: firstname.lastname@example.org.
No funding was received for this study.
The authors have no conflicts of interest to disclose.
The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Army, the Department of Defense, or the US Government.
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