SAT-112 Vulvovaginal Obliteration: Presentation of Eleven Cases

Abstract Disclosure: C. Dominguez-Bali: None. W.K. Massah: None. M.A. Bencomo: None. E. Johnson: None. K. McCoy: None. E.S. Tsehaye: None. H.A. Goraya: None. M.A. Syed: None. R. Polam: None. L. Yousif: None. A. Dominguez-Bali: None. Vulvo-vaginal obliteration is a rare condition, with fewer than 25 cases reported in the literature. This study presents 11 cases of vulvovaginal obliteration, with 3 cases of complete and 8 cases of partial obliteration. A shared characteristic among these patients was a prolonged period (10-35 years) without sexual activity and the absence of hormone therapy.This study aims to examine the presentation, treatment, and outcomes in patients with vulvovaginal obliteration, with a focus on the role of dilator and hormone therapy in post-operative management and potential enhancements in sexual function and prevention of the genitourinary syndrome of menopause consequences.This retrospective analysis included 11 cases of vulvovaginal obliteration. In the two most severe cases, patients presented with symptoms including total urinary retention, urocolpos, bladder distention, bilateral megaloureters, and hydronephrosis with abnormal renal function tests. Emergency procedures were performed to open the inter-labial fusion for urine drainage, followed by treatment with vaginal estradiol and gradual introduction of vaginal dilators.Immediate relief of symptoms was achieved upon opening the inter-labial fusion, with continuous urine drainage lasting up to 45 minutes. While vaginal estradiol alone was insufficient for maintaining the vaginal opening, the introduction of vaginal dilators proved effective. Over time, the required frequency of dilator use decreased. Notably, one patient (92 years old) reported experiencing orgasm for the first time following the use of dilators as a pelvic physical therapy.Early recognition and intervention are essential for managing vulvovaginal obliteration, with vaginal dilators playing a crucial role in post-operative care. But we would like to emphasize the importance of sexual activity (with or without a partner, and in this case, with the use of dilators) and local hormone replacement therapy in the prevention of this kind of severe manifestations of the genitourinary syndrome of menopause. The findings suggest that dilator use may offer therapeutic benefits beyond maintaining patency, potentially enhancing sexual function. Further research is needed to evaluate management options for vulvovaginal obliteration and similar conditions, including those resulting from Stevens-Johnson syndrome, radiation, and chemotherapy. Presentation: Saturday, July 12, 2025