ADOLESCENT AND PEDIATRIC GYNECOLOGY: Edited by Eduardo Lara-TorrePrimary vaginal dilation for vaginal agenesis: strategies to anticipate challenges and optimize outcomesOelschlager, Anne-Marie Amiesa; Debiec, Katherinea; Appelbaum, HeatherbAuthor Information aDepartment of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington bDepartment of Obstetrics and Gynecology, Hofstra-Northwell School of Medicine, Hempstead, New York, USA Correspondence to Anne-Marie Amies Oelschlager, MD, Associate Professor, Department of Obstetrics and Gynecology, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356460, Seattle, WA 98195, USA. Tel: +1 206 987 3005; fax: +1 206 987 3959; e-mail: [email protected] Current Opinion in Obstetrics and Gynecology: October 2016 - Volume 28 - Issue 5 - p 345-349 doi: 10.1097/GCO.0000000000000302 Buy Metrics Abstract Purpose of review Primary vaginal dilation is patient controlled, safe, less painful, and much lower cost compared with operative vaginoplasty and is considered first-line treatment for vaginal agenesis for women with Mayer–Rokitansky–Küster–Hauser syndrome and androgen insensitivity syndrome. Recent findings This review will highlight studies that assess the optimal methods of primary vaginal dilation and clarify ideal counseling, frequency of dilation, management of side-effects, and long-term physical and psychological outcomes. Summary Providers who care for women with vaginal agenesis should be prepared to not only teach the technical skill of dilation, but also to assess readiness and troubleshoot symptoms associated with dilation. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.