Abstract
Chronic graft-versus-host disease is the most common late complication following allogeneic hematopoietic stem cell transplantation. The aim of this study was to present the outcomes of two successful vaginal reconstructions. Patient 1 received chemotherapy for leukemia and underwent bone marrow transplantation (BMT). The patient was sexually inactive for 9 years. In 2012, she was diagnosed with complete vaginal obliteration and underwent vaginal reconstruction. Patient 2 underwent chemotherapy (myeloablative therapy), was sexually inactive for 3 years and was then diagnosed with complete vaginal obliteration. In January 2013, she had vaginal reconstruction with cervical dilatation. Hormonal replacement therapy was administered to both patients. The results of dedicated questionnaires revealed decent quality-of-life and normal sexual functioning and continence status after surgery. Obliteration of the vagina after BMT can be prevented, but if it occurs, vaginal reconstruction surgery should be offered to any patients suffering from obliteration. Our results show that this therapy enables patients to have normal sexual lives without compromising their continence status.
Highlights
Chronic graft-versus-host disease is the most common late complication following allogeneic hematopoietic stem cell transplantation
Studies show that all patients surviving allo-HSCT between 30 and 90% develop Chronic graft-versus-host disease (cGvHD), which is associated with decreased quality of life (Sutherland et al, 1997)
Both patients completed the Short Form (36) Health Survey (SF-36v2), the Female Sexual Function Index (FSFI), the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ 12), the Urogenital Distress Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7) before their surgeries to assess the various aspects of their quality of life (Rogers, Coates, Kammerer-Doak, Khalsa, & Qualls, 2003; Sutherland et al, 1997; Uebersax et al, 1995; Ware & Sherbourne, 1992)
Summary
Chronic graft-versus-host disease (cGvHD) is the most common late complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT). We present the long-term follow-up data collected from two female patients who were suffering from severe genital GvHD, namely the complete obliteration of their vaginas after allo-HSCT, and had successful vaginal reconstruction in our department (the first in 2012, the second in 2013). These operations were previously described and published (Rechberger, Kulik-Rechberger, Winkler, & Perżyło, 2013)
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