Vaginoplasty using autologous in vitro cultured vaginal tissue in a patient with Mayer-von-Rokitansky-Kuster-Hauser syndrome

Abstract

Mayer-von-Rokitansky-Küster-Hauser syndrome (MRKHS) is characterized by vaginal agenesis with variable Müllerian duct abnormalities. The Abbè-McIndoe technique is considered a valid treatment option for vaginoplasty but no consensus has been reached on what material should be used for the neovagina canal wall lining. We report the first case of autologous vaginal tissue transplantation in a 28-year-old women with MRKHS. The patient was subjected to a 1 cm2 full-thickness mucosal biopsy from the vaginal vestibule. Following enzymatic dissociation, cells were inoculated onto collagen IV-coated plates and cultured for 2 weeks. The patient was subjected to a vaginoplasty with a modified Abbè-McIndoe vaginoplasty with 314 cm2 autologous in vitro cultured vaginal tissue for the canal lining. At 1 month from surgery, the vagina appeared normal in length and depth and a vaginal biopsy revealed normal vaginal tissue. The use of autologous in vitro cultured vaginal tissue to create a neovagina appears as an easy, minimally invasive and useful method.