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. 2022 Dec;44(12):1110-1116.
doi: 10.1055/s-0042-1756214. Epub 2022 Sep 22.

Three-dimensional Printer Molds for Vaginal Agenesis: An Individualized Approach as Conservative Treatment

Marina Silva Fernandes  1 , Claudia Cristina Takano  1 , Thyeres Teixeira Bueno Chrispin  1 , Gisele Vissoci Marquini  1 , Manoel João Batista Castello Girão  1 , Marair Gracio Ferreira Sartori  1
Affiliations

Three-dimensional Printer Molds for Vaginal Agenesis: An Individualized Approach as Conservative Treatment

Marina Silva Fernandes et al. Rev Bras Ginecol Obstet. 2022 Dec.

Abstract
in English, Portuguese

Objective: The aim of this study was to evaluate the use of vaginal molds, made with three-dimensional (3D) printing, for conservative treatment through vaginal dilation in patients with vaginal agenesis (VA).

Methods: A total of 16 patients with a diagnosis of VA (Mayer-Rokitansky-Küster-Hauser syndrome, total androgen insensitivity syndrome, and cervicovaginal agenesis) from the Federal University of São Paulo were selected. Device production was performed in a 3D printer, and the polymeric filament of the lactic polyacid (PLA) was used as raw material. A personalized treatment was proposed and developed for each patient.

Results: There were 14 patients who reached a final vaginal length of 6 cm or more. The initial total vaginal length (TVL) mean (SD) was 1.81(1.05) and the final TVL mean (SD) was 6.37 (0.94); the difference, analyzed as 95% confidence interval (95% CI) was 4.56 (5.27-3.84) and the effect size (95% CI) was 4.58 (2.88-6.28).

Conclusion: The 3D printing molds for vaginal dilation were successful in 87.5% of the patients. They did not present any major adverse effects and offered an economical, accessible, and reproducible strategy for the treatment of VA.

Objetivo: O objetivo deste estudo foi avaliar o uso de moldes dilatadores vaginais, confeccionados com impressão tridimensional (3D), para tratamento conservador através da dilatação vaginal em pacientes com agenesia vaginal (AV). MéTODOS: Foram selecionadas 16 pacientes com diagnóstico de AV (síndrome de Mayer-Rokitansky-Küster-Hauser, síndrome de insensibilidade androgênica total e agenesia cervicovaginal), da Universidade Federal de São Paulo. A produção dos dispositivos foi realizada em uma impressora 3D e, como matéria-prima, foi utilizado o filamento polimérico do poliácido lático (PLA). Um tratamento personalizado foi proposto e desenvolvido para cada paciente.

Resultados: Quatorze pacientes atingiram um comprimento vaginal final (CVF) de 6 cm ou mais. A média inicial do CVF (DP) foi de 1,81 (1,05) e a média final do CVF (DP) 6,37 (0,94); a diferença (IC 95%) foi de 4,56 (5,27–3,84) e o tamanho do efeito (IC 95%) foi de 4,58 (2,88–6,28). CONCLUSãO: Os moldes de impressão 3D para dilatação vaginal obtiveram sucesso em 87,5% das pacientes. Como impacto secundário, não apresentaram efeitos adversos importantes e ofereceram uma estratégia econômica, acessível e reprodutível para o tratamento da AV.

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Conflict of interest statement

The authors have no conflict of interests to declare.

Figures

Fig. 1
Fig. 1
Vaginal dilators created with 3D printing. Source : Marta Maria Kemp.
Fig. 2
Fig. 2
Positioning the dilator into vaginal introitus (purple). Source : Marta Maria Kemp.
Fig. 3
Fig. 3
Orientation of perineal massage with the dilator. Source : Marta Maria Kemp.
Fig. 4
Fig. 4
Time of use of the prosthesis and the evolution of total vaginal length of each patient.
See this image and copyright information in PMC

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