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Vol 2, No 1 (2004)
Review paper
Published online: 2004-03-19

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Psychological problems affecting patients with congenital malformations of genital organs

Grażyna Jarząbek, Zbigniew Friebe, Agnieszka Szafińska
Seksuologia Polska 2004;2(1):5-10.

Abstract

Congenital developmental anomalies of the female genital tract are related to disturbances of sexual differentiation. They result from the abnormal development of genital paramesonephric Müllerian ducts and urogenital sinus, that are the structures involved in the process of oviduct’s, uterus, and vagina’s organogenesis. Teratogenic factors acting about 8–10 weeks of embryonic life are the general cause of these malformations. Extent and intensification of abnormalities depend on kind of evoking factor and time of its activity (gestational age, duration). The aim of the study was to analize the correlation betwe- between en the severity of malformation of genital organs to psychological status of the patient. Female patients with congenital anomalies of the genital tract, hospitalised in Gynecogical Clinic were analysed. All presented patients needed multidirectional diagnostics and treatment.
Malformations diagnosed in the patients were divided into the following groups:
Group I: Congenital atresias of the female genital tract (gynatresias) - imperforate hymen; all treated effectively by incision of hymen (hymenectomy).
Group II: Vaginal and uterine septa; these malformations develop in fetal period as a consequence of inappropriate degeneration of paramesonephric ducts’ opposed walls.
Group III: Duplications of the female genital organs-double uterus and vagina; these malformations arise from complete failure of unification of the paramesonephric ducts in parts that normally join to form uterus and vagina.
Group IV: Rudimentary genital tract and genital tract hypoplasia; these malformations follow an incomplete development of paramesonephric Müllerian ducts.
Group V: Congenital absence of the vagina and uterus (aplasia) - the Rokitansky syndrome. It was proved that reactions to the information about diagnosed anomaly and then patients’ attitudes toward treatment vary with a kind of malformation, patient’s age and personality.
Consciousness of severe malformations, especially connected with inabilityto give birth, has strong influence on patient’s mind.
The worse psychical status was observed in group V.
It is essential to point, that clinical menagement of patients with malformations of the genital tract, particularly in Rokitansky syndrome, must include psychological counselling.

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