Abstract
Optimum therapeutic approach in vaginal agenesis has always been an area of extensive controversies. Although surgical management gained priority due to the evolution of techniques, there is currently no consensus in the literature regarding the best type of surgical approach. The most commonly preferred surgical procedure among gynecologists is McIndoe operation which involves the creation of a space between bladder and rectum, insertion of a mold covered with split-thickness skin graft into that neovaginal space, and use of postoperative vaginal dilation to avoid stenosis. However, many modifications have been introduced in time in an attempt to increase the success rates. In this paper, we describe two cases with vaginal agenesis with functioning uterus who were subjected to surgery by combined abdominal-perineal approach. The surgical technique also included the use of a specially designed vaginal mold made up of polymethyl methacrylate and use of Hyalobarrier gel which is an adhesion-preventing agent.
Highlights
Vaginal agenesis is a rare condition with an incidence ranging from 1 in 4,000 to 1 in 10,000 females [1]
The most commonly preferred surgical procedure among gynecologists is McIndoe operation which involves the creation of a space between bladder and rectum, insertion of a mold covered with split-thickness skin graft into that neovaginal space, and use of postoperative vaginal dilation to avoid stenosis [3, 5, 6]
The aim of this paper is to report two cases of vaginal agenesis with functioning uterus who were subjected to a new surgical technique including the use of a specially designed vaginal mold made up of polymethyl methacrylate and use of Hyalobarrier gel, an agent originally used to prevent postoperative adhesions
Summary
Vaginal agenesis is a rare condition with an incidence ranging from 1 in 4,000 to 1 in 10,000 females [1]. The most common etiology is Rokitansky-Kuster-Hauser-Mayer (RKHM) syndrome or Mullerian agenesis which is described as congenital absence of uterus and vagina in an individual with normal female genotype, normal secondary sexual characteristics, and normal ovaries. Many modifications have been introduced in course of time regarding the mold features, surgical technique, and postoperative care to obtain increased therapeutic success with relatively low morbidity. The aim of this paper is to report two cases of vaginal agenesis with functioning uterus who were subjected to a new surgical technique including the use of a specially designed vaginal mold made up of polymethyl methacrylate and use of Hyalobarrier gel, an agent originally used to prevent postoperative adhesions
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