Objective:
The aim of the present study was to study vaginal (as opposed to cervical) HPV acquisition
with regard to true prevalence, HPV types, and the role of co-factors in virgins and
after their sexual debut.
Materials and methods:
This is a prospective epidemiological observational study conducted at a university
hospital specialized in genital malformations.
The study included 186 MRKH patients undergoing neovaginoplasty between November 2011
and July 2017 before and after sexual debut.
Conventional vaginal cytology and different HPV tests were performed at surgery and
during routine gynecological follow-up 1, 3, 6 and ≥11 months after surgery and risk
factors were documented. The study was approved by the local Ethics Committee.
Results:
The mean age of all patients at surgery was 20.1 years. In 83 vaginal samples from
41 different patients at least one of the HPV tests was positive. 33 different HPV
types were detected. The prevalence of 41/186 = 22.0% as well as type distribution
is comparable to that of a young German female population. The overall rate of acquisition
was clearly associated with sexual activity and smoking habits. Out of 367 Pap smears
only 6 were abnormal with Pap IIID (MN II) and no obvious vaginal lesion was detected.
Conclusions:
Vaginal HPV prevalence and HPV types in previously virgin patients after creation
of a neovagina is not different from the acquisition of cervical infections in the
general population and is clearly associated with sexual activity and with smoking
habits. Abnormal Pap smears are however rarely seen.
