EXPERIENCE WITH PREFORMED PHYSICAL FACTORS DURING MAYER-ROKITANSKY-KUSTER-HAUSER SYNDROME
The purpose of the study is to evaluate the effectiveness and tolerability of dilation procedures in combination and without physical effects in the formation of vagina with adolescent girls. Material and methods. There has been conducted a prospective cohort study of 64 adolescent girls at the age of 15 to 18 years old with a first-time diagnosis of vaginal and uterine aplasia. Their psychophysiological features were analyzed with testing according to the questionnaire of well-being, activity, mood (WAM), a gynecological examination was performed to determine the depth of the vaginal fossa. The teenage girls were randomized into 2 groups: group 1 (n=36) - a method of apparatus dilation to create an artificial vagina; the second group of the patients (n=28) underwent preformed physiotherapy with subsequent dilation. All the girls daily made a graph of the increase in the length of the vagina and determined the intensity of pain using a visual-analogue scale (VAS). After the treatment the patients were re-tested according to WAM method. Results. A significant increase in the length of the neovagina was noted in the group of complex treatment with physiotherapy already during the 8<sup>th</sup> procedure, with its increase after the completion of 20 procedures. In group 2, the dynamics of pain intensity significantly decreased in comparison with the 1<sup>st</sup> group. Psychological status of almost half of the patients according to WAN before the beginning of the treatment was characterized as an unfavorable state; after the treatment, their mood and well-being improved. Conducting course procedures of dilation with the use of physiotherapy with girls suffering from vaginal aplasia has a significant decrease in pain and allows to achieve the necessary anatomical length in shorter time compared to the standard method. Conclusion. The use of preformed physical factors in Mayer-Rokitansky-Kuster-Hauser syndrome (dilation) in combination and without physio effect with adolescent girls provides an increase in therapeutic measures.