Psychological impact of neovagina creation and uterus transplantation in the patients affected from Mayer–Rokitanski–Kuster–Hauser syndrome: A narrative review

IF 2.1 4区 医学 Q2 OBSTETRICS & GYNECOLOGY European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2024-10-05 DOI:10.1016/j.ejogrb.2024.09.041
Basilio Pecorino , Giuseppe Scibilia , Martina Ferrara , Pierfrancesco Veroux , Liliana Mereu , Alessandro Serretti , Paolo Scollo
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Abstract

Mayer–Rokitanski–Kuster–Hauser (MRKH) syndrome consists of a congenital aplasia of the uterus and the upper part of the vagina. It is the most frequent congenital cause of absolute uterine factor infertility, determining psychological disorders due to infertility and reduced quality of sexual activity. Being the necessity of baseline and prolonged assessments, clinicians need evaluation parameters for the monitoring of patients to plan a suitable management strategy and for efficient support before and after interventions, such as neovagina and uterus transplantation.
Research of the literature was performed in PubMed and SCOPUS by searching for the terms “Mayer-Rokitanski-Kuster-Hauser” AND “psychological disorders”; from the 60 articles obtained, only 35 articles regarding neovagina creation and uterus transplantation were considered for the present manuscript.
Based on the literature, management of MRKH syndrome by neovagina creation, either surgically or not, can restore a satisfactory sexual life and to reduce stress, signs of mental disorder and depression and improve sexual activity and quality of life.
A psychological assessment of candidates to UT and of their partners is necessary. Recipients had low levels of anxiety compared to the normal population at baseline but a transiently lowered physical quality of life 1 year after surgery; elevated anxiety scores are associated with childlessness in the long-term evaluation.
Further research is necessary to develop suitable evaluation protocols and adequate supportive services, to improve the outcomes of patients who undergo neovagina creation and uterus transplantation.
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新阴道创建和子宫移植对 Mayer-Rokitanski-Kuster-Hauser 综合征患者的心理影响:叙述性综述。
梅尔-罗基坦斯基-库斯特-豪泽尔(MRKH)综合征是一种先天性子宫和阴道上部发育不良的疾病。这是造成绝对子宫因素性不孕的最常见先天性原因,决定了不孕症和性活动质量下降导致的心理障碍。由于有必要进行基线和长期评估,临床医生需要评估参数来监测患者,以规划合适的管理策略,并在新阴道和子宫移植等干预措施前后提供有效支持。通过在 PubMed 和 SCOPUS 上以 "Mayer-Rokitanski-Kuster-Hauser "和 "心理障碍 "为关键词进行搜索,对相关文献进行了研究;从获得的 60 篇文章中,只有 35 篇与新阴道创建和子宫移植有关的文章被纳入本手稿的考虑范围。根据文献资料,通过手术或不手术创建新阴道来治疗 MRKH 综合征,可以恢复令人满意的性生活,减少压力、精神障碍和抑郁症的迹象,改善性活动和生活质量。有必要对UT候选人及其伴侣进行心理评估。与正常人群相比,受术者的基线焦虑水平较低,但术后 1 年的身体生活质量却短暂下降;在长期评估中,焦虑分数的升高与无子女有关。有必要开展进一步研究,以制定合适的评估方案和提供充分的支持服务,从而改善新阴道创建和子宫移植患者的治疗效果。
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来源期刊
CiteScore
4.60
自引率
3.80%
发文量
898
审稿时长
8.3 weeks
期刊介绍: The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.
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