Declining incidence of acquired gynetresia; improved access to healthcare?

Abstract Introduction Acquired vaginal stenosis known as gynetresia has remained more common than the congenital type in developing countries where women engage in all manner of harmful practices including insertion of corrosives into the vagina, female genital mutilation among others. Objective The objectives of the study were to find out the current prevalence of acquired gynetresia, the pattern of presentation, associated risk factors, treatment modalities employed and the outcomes of such care. Methods A retrospective study of gynetresia (vagina stenosis) cases managed at our facility over a 20years period (2000 - 2019). The total admission over the period under study was retrieved from the hospital records department as well as indexed cases for vagina stenosis/atresia. The medical records of women managed for vagina stenosis were retrieved. Data was extracted from these records with the aid of proforma and was imputed into the IBM SPSS version 25 software and analyzed by the same software. Results The prevalence rate of acquired gynetresia was found to be 3/1000 gynecological admission. This is more than 50% decline from the findings of 7/1000 previously demonstrated in a 30years retrospective study done 20years earlier at the same center. Majority of cases (64%) resulted from vagina insertion of corrosives. These corrosives were prescribed or administered by traditional healers to treat uterine fibroid and/or infertility. Other causes were poorly managed birth injuries and female genital mutilation. most of them presented with narrowing of the vagina, dyspareunia with or without apareunia, amenorrhea or hypomenorrhea with associated cyclical abdominal pains. Infertility was common. The commonest form of intervention was vaginoplasty with or without skin grafting with 80-90% success characterized by restoration of satisfactory sexual and menstrual functions and some reported cases of pregnancies. Conclusions Acquired gynetresia though preventable remains prevalent in developing nations. Concerned authorities should intensify efforts at public education and eradication of harmful sociocultural and healthcare practices that may result in gynetresia. Disclosure No