{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:47:20Z","timestamp":1778201240224,"version":"3.51.4"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,14]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Contradictory findings on sexual health in women with Mayer-Rokitansky-Kuester-Hauser syndrome (MRKHS) after vaginal reconstruction point toward the need for more profound assessment of this subject, particularly as it is still unclear what constitutes sexual well-being, especially genital self-image or sexual self-esteem, in women with MRKHS and neovagina.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this qualitative study was to assess individual sexual health and sexual well-being in the context of MRKHS after vaginal reconstruction, with an emphasis on genital self-image, sexual self-esteem, sexual satisfaction, and coping with MRKHS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Qualitative semistructured interviews were conducted with women with MRKHS after vaginal reconstruction (n\u2009=\u200910) with the Wharton-Sheares-George surgical method and a matched control group without MRKHS (n\u2009=\u200920). Women were surveyed about their previous and current sexual activities, perception of and attitudes toward their genitals, disclosure to others, coping with the diagnosis, and perception of surgery. Data were analyzed through qualitative content analysis and compared with the control group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes<\/jats:title><jats:p>The primary outcomes of the study were major categories, such as sexual satisfaction, sexual self-esteem, genital self-image, and dealing with MRKHS, as well as subcategories related to the content analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Although half the women in the present study indicated that they were coping well with their condition and were satisfied with sexual intercourse, most felt insecure about their neovagina, were cognitively distracted during intercourse, and showed low levels of sexual self-esteem.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Implications<\/jats:title><jats:p>A better understanding of expectations and uncertainties regarding the neovagina might help professionals to support women with MRKHS after vaginal reconstruction to increase sexual well-being.<\/jats:p><\/jats:sec><jats:sec><jats:title>Strengths and Limitations<\/jats:title><jats:p>This is the first qualitative study focusing on individual aspects of sexual well-being, especially sexual self-esteem and genital self-image, in women with MRKHS and neovagina. The qualitative study indicates good interrater reliability and data saturation. The limitations of this study include the inherent lack of objectivity resulting from the method but also the fact that all the patients had a particular surgical technique, consequently resulting in limited generalizability of these findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our data indicate that integrating the neovagina into the genital self-image is a prolonged process that is essential for sexual well-being and should thus be the focus of sexual counseling.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jsxmed\/qdac011","type":"journal-article","created":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T09:07:56Z","timestamp":1673514476000},"page":"57-64","source":"Crossref","is-referenced-by-count":6,"title":["Sexual health and sexual well-being of women with Mayer-Rokitansky-Kuester-Hauser syndrome after vaginal reconstruction: a qualitative analysis"],"prefix":"10.1093","volume":"20","author":[{"given":"Clara","family":"Stepanow","sequence":"first","affiliation":[{"name":"Department of Psychoanalysis and Psychotherapy, Medical University Vienna , Vienna A-1090 , Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Naderer","sequence":"additional","affiliation":[{"name":"Department of Psychoanalysis and Psychotherapy, Medical University Vienna , Vienna A-1090 , Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Alexopoulos","sequence":"additional","affiliation":[{"name":"Department of Psychoanalysis and Psychotherapy, Medical University Vienna , Vienna A-1090 , Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Walch","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Medical University Vienna , Vienna A-1090 , Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rene","family":"Wenzl","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Medical University Vienna , Vienna A-1090 , Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Leithner","sequence":"additional","affiliation":[{"name":"Department of Psychoanalysis and Psychotherapy, Medical University Vienna , Vienna A-1090 , Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,1,12]]},"reference":[{"issue":"1","key":"2023031014052397100_","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1186\/s13023-020-01491-9","article-title":"Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome: a comprehensive update","volume":"15","author":"Herlin","year":"2020","journal-title":"Orphanet J Rare Dis"},{"issue":"6","key":"2023031014052397100_","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.jgyn.2008.07.002","article-title":"The Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome: clinical description and genetics","volume":"37","author":"Morcel","year":"2008","journal-title":"J Gynecol Obstet Biol Reprod (Paris)"},{"key":"2023031014052397100_","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1055\/s-0029-1224720","article-title":"Das Mayer-Rokitansky-K\u00fcster-Hauser-Syndrom, Eine \u00dcbersicht \u00fcber den Stand der internationalen psychosomatischen Forschung","volume":"22","author":"Huber","year":"2009","journal-title":"Z Sexualforsch"},{"issue":"1","key":"2023031014052397100_","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/1354850021000059232","article-title":"Living with an incomplete vagina and womb: an interpretative phenomenological analysis of the experience of vaginal agenesis","volume":"8","author":"Holt","year":"2003","journal-title":"Psychol Health Med"},{"issue":"2","key":"2023031014052397100_","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.jpag.2020.11.009","article-title":"The missing uterus, the missed diagnosis, and the missing care. 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