Materials and Methods: A retrospective analysis was conducted on 26 patients with complete vaginal agenesis from February 2012 to March 2022. Parameters such as neovaginal dimensions, granulation tissue, and stenosis were monitored during follow-up appointments. The primary outcome assessed was achieving both anatomical and functional success. The Female Sexual Function Index (FSFI) was used to evaluate sexual function, with a comparison made to 49 healthy women who completed the FSFI to gauge sexual function.

Results: The average neovaginal length was 7.76 ± 1.55 cm, with a width equivalent to two fingers. While women with neovaginal lengths ≥ 6 cm had higher mean FSFI scores (23.78 ± 3.65) than those with lengths <6 cm (19.15 ± 7.00), this difference was not statistically significant (P = 0.117). We could not find any difference in FSFI domain scores after vaginoplasty according to the neovaginal lengths (P > 0.05). However, in MRKH syndrome patients, the “arousal” (P = 0.040) and “lubrication” scores were higher than those of the control group (P = 0.004). The full FSFI score was also significantly higher in the MRKH group compared to controls (P = 0.023).

Conclusions: Vaginoplasty utilizing a peritoneal graft shows promise as a surgical treatment for vaginal agenesis in individuals with MRKH syndrome, though larger studies are needed to confirm its long-term efficacy and safety.