Safety and efficacy of Vecchietti vaginoplasty in vaginal agenesis: cohort study. Medellín, Colombia 2007-2012
DOI:
https://doi.org/10.18597/rcog.3177Keywords:
Reconstructive surgical procedures, vaginal diseases, androgen resistance syndromeAbstract
Objective: To describe the Vecchietti vaginoplasty technique (VVT) in patients diagnosed with secondary vaginal agenesis and to analyze the safety and effica-cy of this technique.
Materials and methods: Historical cohort of patients with vaginal agenesis sec-ondary to Mayer-Rokitansky-Kuster-Hauser and androgen insensitivity syn-dromes, subjected to vaginoplasty using the Vecchietti technique at San Vicente Fundación University Hospital, a high complexity referral institution located in the city of Medellín, during the time period between 2007 and 2012. Patients with functional a vagina for intercourse were excluded. Sampling was consecutive. Sociodemographic, clinical, safety and efficacy variables were measured. De-scriptive statistics were used.
Results: The main complaint was primary amenorrhea (69.2%). Associated mal-formations included right renal agenesis (15.4%) and skeletal malformations (15.4%). There was one intra-operative bladder perforation and, postoperatively, there were three (23.1%) minor complications. At 1-year follow-up, a functional vagina had been obtained in 84.6% of cases.
Conclusion: Vecchietti vaginoplasty is a simple surgical technique resulting in satisfactory functional outcomes with only minor complications. Further studies with control groups are required in order to better assess the efficacy of the vari-ous techniques used for neovagina creation.
Author Biographies
Jorge Enrique Aristizábal-Duque, Departamento de Ginecología y Obstetricia Universidad de Antioquia
Médico y cirujano; especialista en Ginecología y Obstetricia; especialista en Medicina Reproductiva. Profesor del Departamento de Ginecología y Obstetricia de la Universidad de Antioquia, Medellín, Colombia.
Joan Camilo Piedrahíta-Mejía, Departamento de Ginecología y Obstetricia Universidad de Antioquia
Médico y cirujano; especialista en Epidemiología; especialista en Edición de Publicaciones. Profesor del Departamento de Ginecología y Obstetricia de la Universidad de Antioquia, Medellín, Colombia.
References
Capraro VJ, Gallego MB (1976) Vaginal agenesis. Am J Obstet Gynecol. 1976;124(1):98-107. DOI: https://doi.org/10.1016/0002-9378(76)90020-X
Michala L, Cutner A, Creighton SM. Surgical approaches to treating vaginal agenesis. BJOG. 2007;114(12):1455-9. https://doi.org/10.1111/j.1471-0528.2007.01547.x
Creatsas G, Deligeoroglou E. Vaginal aplasia and reconstruction. Best Pract Res Clin Obstet Gynaecol. 2010;24(2):185-91. https://doi.org/10.1016/j.bpobgyn.2009.11.002
Bouman M, van Zeijl MC, Buncamper ME, et al. Intestinal vaginoplasty revisited: A review of surgical techniques, complications, and sexual function. J Sex Med. 2014;11: 1835-47. https://doi.org/10.1111/jsm.12538
Pravin M, Jyoti M, Rakhi S. New laparoscopic peritoneal pull-through vaginoplasty technique. Reprod Sci. 2014;24(6):181-6.
Edmons DK, Rose GL, Lipton MG, Quek J. Mayer- Rokitansky-Küster-Hauser Syndrome: A review of 245 consecutive cases managed by a multidisciplinary approach with vaginal dilators. Fertil Steril. 2012;97(3):686-90. https://doi.org/10.1016/j.fertnstert.2011.12.038
ACOG Committee on Adolescent Health Care. ACOG Committee Opinion. Nonsurgical diagnosis and management of vaginal agenesis. Obstet Gynecol. 2002;100(1):213-6. https://doi.org/10.1097/00006250-200207000-00034
Kuhn A, Neukomm C, Dreher EF, Imobersteg J, Mueller MD. Prolapse and sexual function 8 years after neovagina according to Shears: A study of 43 cases with Mayer-von Rokitansky-Küster-Hauser syndrome. Int Urogynecol J. 2013;24(6): 1047-52. https://doi.org/10.1007/s00192-012-1980-z
Templeman CL, Lam AM, Hertweek SP. Surgical management of vaginal agencies. Obstet Gynecol Sur v. 1999;54(9):583-91. https://doi.org/10.1097/00006254-199909000-00023
Vecchietti G. Le neo-vagin dans le syndrome de Rokitansky-Küster-Hauser. Rev Med Suisse Romande. 1979;99(9):593-601.
Brucker SY, Gegusch M, Zubke W, Rall K, Gauwerky JF, Wallwiener D. Neovagina creation in vaginal agenesis: Development of a new laparoscopic Vecchietti-based procedure and optimized instruments in a prospective comparative interventional study in 101 patients. Fertil Steril. 2008;90(5):1940-52. https://doi.org/10.1016/j.fertnstert.2007.08.070
Fedele L, Busacca M, Candiani M, Vignali M. Laparoscopic creation of a neovagina in Mayer-Rokitansky- Küster syndrome by modification of Vecchietti’s operation. Am J Obstet Gynecol. 1994;171(1):268-9. https://doi.org/10.1016/0002-9378(94)90482-0
Cihan C, Cenk S, Ibrahim F, Murat A, Turan C. Long-term outcomes of laparoscopic bean vaginoplasty (modified Vecchietti procedure) for Mayer- Rokitansky-Kuster-Hauser Syndrome. J Laparoendosc Adv Surg Tech. 2016;26(8): 591-5. DOI: https://doi.org/10.1089/lap.2016.0031
McQuillan SK, Grover SR. Dilation and surgical management in vaginal agenesis: A systematic review. Int Urogynecol J. 2014;(25):299-311. https://doi.org/10.1007/s00192-013-2221-9
Pastor Z, Fronek J, Nováčková M, Chmel R. Sexual life of women with Mayer-Rokitansky-Küster-Hauser Syndrome after laparoscopic Vecchietti vaginoplasty. Sex Med. 2017;5(2):e106-e113. https://doi.org/10.1016/j.esxm.2016.12.003
How to Cite
Downloads
Downloads
Published
Issue
Section
License
Copyright (c) 2019 Revista Colombiana de Obstetricia y Ginecología
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Article metrics | |
---|---|
Abstract views | |
Galley vies | |
PDF Views | |
HTML views | |
Other views |