A description of a simplified neovagina technique. A report of 4 cases from Cali, Colombia

Authors

  • Gustavo Gómez-Tabares
  • Albaro José Nieto-Calvache

DOI:

https://doi.org/10.18597/rcog.287

Keywords:

Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome, surgical technique, neovagina

Abstract

Introduction: vaginal agenesis represents a rare malformation, mostly associated with Mayer-Rokitansky-Kuster-Hauser syndrome and androgen insensitivity syndrome or testicular feminisation syndrome. Treatment focuses on restoring sexual function and most surgical techniques are characterised by their complexity and require special instruments. This paper was aimed at presenting a simplified neovagina technique.

Methodology: four cases of patients suffering vaginal agenesis are reported; they underwent a modification of the McIndoe technique by using absorbent antimicrobial barrier dressings which simplifies the procedure and reduces implementation costs. They were followed-up for 8-18 months and suitable results were obtained.

Results: three patients suffering from MRKH syndrome were treated; the fourth one had testicular feminisation syndrome (XY karyotype). A rupture of the distal colon or rectum was seen at the start of surgery in one case; such complication was identified and corrected, presenting suitable evolution. Hospital stay varied from 2-3 days. No medium or long-term complications were presented. Sexual relationships were documented as having begun around 40 days later.

Conclusion: the surgical technique described here represents an option for restoring sexual function in women suffering from this condition.

Author Biographies

Gustavo Gómez-Tabares

Gineco-obstetra. Especialista en Medicina Reproductiva, Unidad de Endocrinología Reproductiva, Departamento de Ginecología y Obstetricia, Hospital Universitario del Valle. Cali (Colombia).

Albaro José Nieto-Calvache

Residente Ginecología y Obstetricia, Universidad del Valle. Cali (Colombia).

References

Evans PN, Poland NL, Boving RL. Vaginal malformations. Am J Obstet Gynecol 1981;141:910-20.

Rock JA, Azziz R. Genitalia anomalies in childhood. Clin Obstet Gynecol 1987;30:682-96.

Malewski AW, Czaplicki M, Kryst P. Congenital abnormality of the urinary tract in Mayer-Rokitansky-Kuster-Hauser syndrome. Ginekol Pol 1992;63:251-4.

Strubbe EH, Lemmens JA, Thijn CJ, Willemsen WN, van Toor BS. Spinal abnormalities and the atypical form of the Mayer-Rokitansky-Kuster-Hauser syndrome. Skeletal Radiol 1992;21:459-62.

Wulfsberg EA, Grigsby TM. Rokitansky sequence in association with the facio-auriculo-vertebral sequence: part of a mesodermal malformation spectrum? Am J Med Genet 1990;37:100-2.

Frank RT. The formation of an artificial vagina without operation. Am J Obstet Gynecol 1938;35:1053-5.

Nichols DH, Randall CL. Creation of a neovagina. En: Nichols DH, Randall CL. Vaginalsurgery. 3rd ed. New York: Appleton;1989. p. 413-25.

Vecchietti G. Neovagina nella syndrome di Rokitansky-Kuster-Hauser. Attual Obstet Ginecol 1965;11:131-47.

Borruto F, Chasen ST, Chervenak FA, Fedele L. The Vecchietti procedure for surgical treatment of vaginal agenesis: comparison of laparoscopy and laparotomy. Int J Gynecol Obstet 1999;64:153-8.

Burger RA, Riedmiller H, Knapstein PG, Friedberg V, Hohenfellner R. Ileocecal vaginal construction. Am J Obstet Gynecol 1989;161:162-7.

Brun J, Belleannée G, Grafeillec N, Asland AF, Brun GH. Long-term results after neovagina creation in Mayer-Rokitanski-Kuster-Hauser syndrome by Vecchietti's operation. Eur J Obstet Gynecol Reprod Biol 2002;103:168-72.

Sheares BH. Congenital atresia of the vagina: a technique for tunneling the space between the bladder and rectum and construction of a new vagina by a modified Wharton-technique. J Obstet Gynecol Br Emp 1960;67:24-31.

Alessandrescu D, Peltecu GC, Buhimschi CS, Buhimschi IA. Neocolpopoiesis with split-thickness skin graft as a surgical treatment of vaginal agenesis: retrospective review of 201 cases. Am J Obstet Gynecol 1996;175:131-8.

Rock JA. Surgery for anomalies of the mullerian ducts. En: Rock JA, Thompson JD, eds. TeLinde's operative gynecology. 50th ed. New York: Lippincott-Raven;1997. p. 687-729.

Fliegner JR. Congenital atresia of the vagina. Surg Gynecol Obstet 1987;175:387-91.

McIndoe AH, Banister JB. An operation for the cure of congenital absence of the vagina. J Obstet Gynaecol Br Empire 1938;45:490-4.

Rothman D. The use of peritoneum in the construction of a vagina. Obstet Gynecol 1972;40:835-8.

Morton KE, Dewhurst CJ. Human amnion in the treatment of vaginal malformations. Br J Obstet Gynaecol 1986;93:50-4.

Gómez G. Síndrome de disgenesia de conductos mullerianos: Agenesia de cuello, 2/3 superiores de vagina. Rev Colomb Obstet Ginecol 1994;45:81-3.

Yu K, Lin Y, Chao K. A detachable porous vaginal mold facilitates reconstruction of a modified McIndoe neovagina. Fertil Steril 2004;81:435-9.

Borruto F. Mayer-Rokitansky-Küster Syndrome: Vecchietti's personal series. Clin Exp Obstet Gynecol 1992;19:273-4.

Creatsas G. Deligeoroglou E, Makrakis E, Kontoravdis A, Papadimitriou L. Creation of a neovagina following Williams vaginoplasty and the Creatsas modification in 111 patients with Mayer-Rokitansky-Küster-Hauser syndrome. Fertil Steril 2008;90:1940-52.

Diener E. Subjective well-being: The science of happiness and a proposal for a national index. Am Psychol 2000;55:34-43.

Andersen BL, Cyranowski JM. Women's sexual self schema. Journal of Personality and Social Psychology 1994;67:1079-100.

How to Cite

1.
Gómez-Tabares G, Nieto-Calvache AJ. A description of a simplified neovagina technique. A report of 4 cases from Cali, Colombia. Rev. colomb. obstet. ginecol. [Internet]. 2010 Jun. 30 [cited 2024 May 16];61(2):169-75. Available from: https://revista.fecolsog.org/index.php/rcog/article/view/287

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2010-06-30
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