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Use of Physical Therapy to Augment Dilator Treatment for Vaginal Agenesis

McVearry, Mary E. DPT; Warner, William B. MD

Female Pelvic Medicine & Reconstructive Surgery: May-June 2011 - Volume 17 - Issue 3 - p 153-156
doi: 10.1097/SPV.0b013e31821bcd83
Case Reports

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:

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.

The authors certify that all individuals who qualify as authors have been listed; each has participated in the conception and design of this work, the writing of the document, and the approval of the submission of this version; that the document represents valid work; that if they used information derived from another source, they obtained all necessary approvals to use it and made appropriate acknowledgements in the document; and that each takes public responsibility for it.

Nothing in the presentation implies any Federal/DOD endorsement.

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.