Sexuality and quality of life of patients operated for Rokitansky syndrome Mayer Kuster Hauser


Khaoula Magdoud
Hassine Saber Abouda
Asma Jellouli
Rim Ben Hmid
Mohamed Badis Chanoufi
Abir Karoui


Introduction: Rokitansky syndrome or Mayer Rokitansky Kuster Hauser (SRKMH) is a rare congenital malformation defined by uterovaginal aplasia. The aim of the treatment is to create a neovagina and restore sexual life. However, postoperative results in terms of sexual and overall quality of life of patients remain controversial.

Aim: To evaluate the quality of life and sexuality of patients operated on for Rokitansky syndrome.

Methods: This was a retrospective and comparative study between two groups of patients. The first group consisted of patients who had undergone vaginoplasty as part of SRKMH. The second group was that of the controls. Control in terms of sexual function by the Ar FSFI (Arab FemaleSexualFunction Index) and quality of life by the SF36 (Short Forms Health Survey) were used in both groups.

Results: The average age of patients operated on for SRKMH was 22.53 years. Eighteen of these patients (60%) were sexually active at the time of the study. Patients operated on for SRKMH had a significantly lower Ar FSFI score compared to the control group. The two areas most affected were lubrication and pain.

  Likewise, patients who underwent vaginoplasty had a significantly lower SF 36 score compared to the control group. The psychological component was the most affected of the different components of quality of life.

Conclusion: Sexual function and quality of life after vaginoplasty in the context of Rokitansky syndrome remains unsatisfactory despite the anatomical result.


Mullerian aplasia , Vaginoplasty, Infertility, Sexuality, Quality of life



  1. Morcel K, Camborieux L, Guerrier D. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Orphanet J Rare Dis. 2007; 14;2:13.
  2. Tsarna E, Eleftheriades A, Eleftheriades M et al. The impact of Mayer-Rokitansky-Küster-Hauser Syndrome on Psychology, Quality of Life, and Sexual Life of Patients: A Systematic Review. Children (Basel). 2022; 1;9(4):484.
  3. Committee on Adolescent Health Care. ACOG Committee Opinion No. 728: Müllerian Agenesis: Diagnosis, Management, And Treatment. Obstet Gynecol. 2018; 131(1):e35-e42.
  4. Ben Hmid R, Touhami O, Zouaoui B et al. Evaluation des différentes techniques de vaginoplastie dans le cadre du traitment du syndrome de Mayer-Rokitansky-Küster-Hauser [Evaluation of different techniques for vaginoplasty in the treatment of Mayer-Rokitansky-Kuster-Hauser syndrome]. Tunis Med. 2012; 90(12):852-5.
  5. Anis TH, Gheit SA, Saied HS et al. Arabic translation of Female Sexual Function Index and validation in an Egyptian population. J Sex Med. 2011; 8(12):3370-8.
  6. Guermazi M, Allouch C, Yahia M, Huissa et al. Translation in Arabic, adaptation and validation of the SF-36 Health Survey for use in Tunisia. Ann Phys Rehabil Med. 2012; 55(6):388-403.
  7. Rosen R, Brown C, Heiman J et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000; 26(2):191-208.
  8. Lean ME, Han TS, Seidell JC. Impairment of health and quality of life using new US federal guidelines for the identification of obesity. Arch Intern Med. 1999; 26;159(8):837-43.
  9. Giannesi A, Marchiole P, Benchaib M et al. Sexuality after laparoscopic Davydov in patients affected by congenital complete vaginal agenesis associated with uterine agenesis or hypoplasia. Hum Reprod. 2005; 20(10):2954-7.
  10. Fotopoulou C, Sehouli J, Gehrmann N et al. Functional and anatomic results of amnion vaginoplasty in young women with Mayer-Rokitansky-Küster-Hauser syndrome. Fertil Steril. 2010; 94(1):317-23
  11. Liu X, Liu M, Hua K et al. Sexuality after laparoscopic peritoneal vaginoplasty in women with Mayer-Rokitansky-Kuster-Hauser syndrome. J Minim Invasive Gynecol. 2009; 16(6):720-9.
  12. Fedele L, Frontino G, Restelli E et al. Creation of a neovagina by Davydov's laparoscopic modified technique in patients with Rokitansky syndrome. Am J Obstet Gynecol. 2010; 202(1):33.e1-6.
  13. Weijenborg PTM, Kluivers KB, Dessens AB et al. Sexual functioning, sexual esteem, genital self-image and psychological and relational functioning in women with Mayer-Rokitansky-Küster-Hauser syndrome: a case-control study. Hum Reprod. 2019; 29;34(9):1661-1673.
  14. Allen LM, Lucco KL, Brown CM et al. Psychosexual and functional outcomes after creation of a neovagina with laparoscopic Davydov in patients with vaginal agenesis. Fertil Steril. 2010; 94(6):2272-6.
  15. Tunuguntla HS, Gousse AE. Female sexual dysfunction following vaginal surgery: a review. J Urol. 2006; 175(2):439-46.
  16. Dabaghi S, Zandi M, Ilkhani M. Sexual satisfaction in patients with Mayer-Rokitansky-Küster-Hauser syndrome after surgical and non-surgical techniques: a systematic review. Int Urogynecol J. 2019; 30(3):353-362.
  17. Kang J, Chen N, Song S et al. Sexual function and quality of life after the creation of a neovagina in women with Mayer-Rokitansky-Küster-Hauser syndrome: comparison of vaginal dilation and surgical procedures. Fertil Steril. 2020; 113(5):1024-1031.
  18. Nakhal RS, Creighton SM. Management of vaginal agenesis. J Pediatr Adolesc Gynecol. 2012; 25(6):352-7.
  19. Touré CT, Dieng M, Diallo D et al. Le traitement de l’aplasie vaginale par colpoplastie sigmoïdienne. L’expérience dakaroise. E-Mém Académie Natl Chir. 2003; 2(4):53–56..
  20. Pizzo A, Laganà AS, Sturlese E et al. Mayer-rokitansky-kuster-hauser syndrome: embryology, genetics and clinical and surgical treatment. ISRN Obstet Gynecol. 2013; 2013:628717.
  21. Gari A. Mclndoe Neovagina in patients with Mullerian Agenesis: A single center experience. Pak J Med Sci. 2017; 33(1):236-240.
  22. Bianchi S, Frontino G, Ciappina et al. Creation of a neovagina in Rokitansky syndrome: comparison between two laparoscopic techniques. Fertil Steril. 2011; 1;95(3):1098-100.e1-3.
  23. Kimberley N, Hutson JM, Southwell BR et al. Well-being and sexual function outcomes in women with vaginal agenesis. Fertil Steril. 2011; 95(1):238-41.
  24. Bean EJ, Mazur T, Robinson AD. Mayer-Rokitansky-Küster-Hauser syndrome: sexuality, psychological effects, and quality of life. J Pediatr Adolesc Gynecol. 2009; 22(6):339-46.
  25. Leithner K, Naderer A, Hartung D et al. Sexual and Psychosocial Functioning in Women with MRKHS after Neovaginoplasty According to Wharton-Sheares-George: A Case Control Study. PLoS One. 2015; 22;10(4):e0124604.