Abstract
Various vaginoplasty procedures have been developed for patients with Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome. Here, we describe a novel laparoscopic vaginoplasty procedure, known as the Kisu modification, using a pull-down technique of the peritoneal flaps with additional structural support to the neovaginal apex using the incised uterine strand in patients with MRKH syndrome. Ten patients with MRKH syndrome (mean age at surgery: 23.9 ± 6.5 years, mean postoperative follow-up period: 17.3 ± 3.7 months) underwent construction of a neovagina via laparoscopic vaginoplasty. All surgeries were performed successfully without complications. The mean neovaginal length at discharge was 10.3 ± 0.5 cm. Anatomical success was achieved in all patients, as two fingers were easily introduced, the neovagina was epithelialized, and the mean neovaginal length was 10.1 ± 1.0 cm 1 year postoperatively. No obliteration, granulation tissue formation at the neovaginal apex, or neovaginal prolapse was recorded. Five of the 10 patients attempted sexual intercourse and all five patients were satisfied with the sexual activity, indicating functional success. Although the number of cases in this case series is few, our favorable experience suggests that the Kisu modification of laparoscopic vaginoplasty procedure is an effective, feasible, and safe approach for neovaginal creation in patients with MRKH syndrome.
Highlights
Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome is a congenital malformation characterized by the defective development of the Müllerian ducts resulting in the absence of a functional vagina and uterus in the presence of normally functioning ovaries
Syndrome, the creation of a neovagina allows for satisfactory sexual intercourse, and uterus transplantation (UTx) can allow patients with Mayer–Rokitansky– Küster–Hauser (MRKH) syndrome to give birth [1]
Several surgical and nonsurgical techniques for creating an adequately sized and functional neovagina to allow for sexual intercourse have been developed for patients with MRKH syndrome [2,3]
Summary
Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome is a congenital malformation characterized by the defective development of the Müllerian ducts resulting in the absence of a functional vagina and uterus in the presence of normally functioning ovaries. In patients with MRKH syndrome, the creation of a neovagina allows for satisfactory sexual intercourse, and uterus transplantation (UTx) can allow patients with MRKH syndrome to give birth [1]. Several surgical and nonsurgical techniques for creating an adequately sized and functional neovagina to allow for sexual intercourse have been developed for patients with MRKH syndrome [2,3]. The laparoscopic Davydov procedure is one of the most commonly used techniques, in which the vesio-rectal space is coated with peritoneum [4]. Various modified laparoscopic Davydov procedures have been developed [6,7,8,9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
