Providers' Experiences with Vaginal Dilator Training for Patients with Vaginal Agenesis

J Pediatr Adolesc Gynecol. 2018 Feb;31(1):45-47. doi: 10.1016/j.jpag.2017.07.006. Epub 2017 Aug 4.


Study objective: To examine providers' experiences with vaginal dilator training for patients with vaginal agenesis.

Design and setting: Anonymous electronic survey.

Participants: Members of the North American Society for Pediatric and Adolescent Gynecology.

Interventions and main outcome measures: How providers learn about vaginal dilator training, common techniques, and methods used for patient training, assessment of patient readiness, common patient complaints, issues leading to early discontinuation.

Results: There were a total of 55 completed survey responses of which 31 respondents (56%) had been in practice for more than 10 years. Forty-nine were gynecologists (89%), 20 had completed a fellowship in pediatric and adolescent gynecology (36%), and 6 were reproductive endocrinologists (11%). Thirty-one respondents had first learned about vaginal dilator training through lectures (56%) whereas only 9 through mentorship and fellowship (16%). According to respondents, the most common issue leading to early discontinuation was lack of patient motivation and readiness (n = 42; 76%). The most common complication was pain or discomfort (n = 45; 82%). More than half of respondents determined dilator therapy was successful when patients reported comfortable sexual intercourse (n = 30; 55%) and 65% (n = 35) did not delineate any restrictions to initiation of sexual intercourse. Most respondents (87%) requested further vaginal dilator training at either a clinical meeting (n = 26; 47%) or with a training video (n = 22; 40%).

Conclusion: Our study in an experienced cohort of pediatric gynecology providers highlights the need for further research and training on vaginal dilation education.

Keywords: Membership survey; North American Society Pediatric Adolescent Gynecology; Patient readiness; Physician experience; Progressive perineal dilatation; Vaginal agenesis; Vaginal dilation; Vaginal dilator.

MeSH terms

  • Adolescent
  • Congenital Abnormalities / surgery*
  • Dilatation / methods*
  • Female
  • Gynecology / education*
  • Humans
  • Patient Education as Topic / methods*
  • Surveys and Questionnaires
  • Vagina / abnormalities*
  • Vagina / surgery

Supplementary concepts

  • Vagina, absence of