Please wait a minute...
Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    2009, Vol. 3 Issue (3) : 347-351     DOI: 10.1007/s11684-009-0059-9
Research articles |
Laparoscopic sigmoid vaginoplasty in women with Mayer-Rokitansky-Kuster-Hauser syndrome
Yi SHEN MD , Guobin WANG MD , Zhoufang XIONG MD , Kaixiong TAO MD , Zehua WANG MD ,
Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China;
Download: PDF(84 KB)  
Export: BibTeX | EndNote | Reference Manager | ProCite | RefWorks
Abstract  The feasibility and clinical therapeutic effects of laparoscopic sigmoid vaginoplasty in women with Mayer-Rokitansky-Kuster-Hauser syndrome (MRKHs) were explored. The records of 11 MRKHs patients who underwent laparoscopic sigmoid vaginoplasty from 2003 to 2005 were reviewed, and long-term results were evaluated by follow-up. The mean operating time was 234min (range, 130―300min), the mean hospital stay was 9.4 days (range, 7―15 days), and the mean hemoglobin drop was 1.91g/dL (range, 1.6―3.2g/dL). A functional neovagina was created measuring 11 to 14cm in length and two fingers in breadth in all patients. No introitus stenosis was observed. No intra-operative or postoperative bowel complication occurred. At the 3rd postoperative month, the first intercourse began. One patient was lost to follow-up. One had no intercourse and was required to wear vaginal mold occasionally. None of the other nine women (100%) complained of local irritation or dyspareunia. They were satisfied with their sexual life. The cosmetic results were excellent. The laparoscopic sigmoid vaginoplasty realizes to make a functional neovagina. The main advantage is its minimal invasiveness. It is an ideal procedure for MRKHs patients.
Keywords Mayer-Rokitansky-Kuster-Hauser syndrome      laparoscopy      sigmoid transplantation vaginoagenesis      
Issue Date: 05 September 2009
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-009-0059-9     OR     http://academic.hep.com.cn/fmd/EN/Y2009/V3/I3/347
Laufer M R. Congenital absence of the vagina: in search of the perfect solution.When, and by what technique, should a vagina be created? Curr Opin Obstet Gynecol, 2002, 14(5): 441―444

doi: 10.1097/00001703-200210000-00001
Folch M, Pigem I, Konje J C. Müllerian agenesis: etiology, diagnosis, and management. Obstet Gynecol Surv, 2000, 55(10): 644―649

doi: 10.1097/00006254-200010000-00023
Davies M C, Creighton S M. Vaginoplasty. Curr Opin Urol, 2007, 17(6): 415―418

doi: 10.1097/MOU.0b013e3282f0d5b3
Baldwin J F. XIV. The formation of an artificial vagina by intestinal transplantation. Ann Surg, 1904, 40(3): 398―403

doi: 10.1097/00000658-190440030-00014
Urbanowicz W, Starzyk J, Sulislawski J. Laparoscopic vaginal reconstruction using a sigmoid colonsegment: a preliminary report. J Urol, 2004, 171(6 Pt 2): 2632―2635

doi: 10.1097/01.ju.0000111342.92168.42
Ota H, Tanaka J, Murakami M, Murata M, Fukuda J, Tanaka T, Andoh H, Koyama K. Laparoscopy-assisted Ruge procedure forthe creation of a neovagina in a patient with Mayer-Rokitansky-Küster-Hausersyndrome. Fertil Steril, 2000, 73(3): 641―644

doi: 10.1016/S0015-0282(99)00570-1
Edmonds D K. Congenital malformations of the genital tract and their management. Best Pract Res Clin Obstet Gynaecol, 2003, 17(1): 19―40

doi: 10.1053/ybeog.2003.0356
Wabrek A J, Millard P R, Wilson W B Jr, Pion R J. Creationof a neovagina by the Frank nonoperative method. Obstet Gynecol, 1971, 37(3): 408―413
McIndoe A H, Banniser J B. An operation for the cureof congenital absence of the vagina. JObstet Gynaecol Br Emp, 1938, 45: 490―494
Roberts C P, Haber M J, Rock J A. Vaginal creation for müllerian agenesis. Am J Obstet Gynecol, 2001, 185(6): 1349―1352

doi: 10.1067/mob.2001.119075
Keckstein J, Buck G, Sasse V, Tuttlies F, Ulrich U. Laparoscopic creation ofa neovagina: modified Vecchietti method. Endosc Surg Allied Technol, 1995, 3(2,3): 93―95
Creatsas G, Deligeoroglou E, Makrakis E, Kontoravdis A, Papadimitriou L. Creation of a neovagina followingWilliams vaginoplasty and the Creatsas modification in 111 patientswith Mayer-Rokitansky-Küster-Hauser syndrome. Fertil Steril, 2001, 76(5): 1036―1040

doi: 10.1016/S0015-0282(01)02836-9
Giannesi A, Marchiole P, Benchaib M, Chevret-Measson M, Mathevet P, Dargent D. Sexuality after laparoscopic Davydov in patients affectedby congenital complete vaginal agenesis associated with uterine agenesisor hypoplasia. Hum Reprod, 2005, 20(10): 2954―2957

doi: 10.1093/humrep/dei152
Liao L, Doyle J, Crouch N S, Creighton S M. Dilation as treatment for vaginal agenesis and hypoplasia: a pilotexploration of benefits and barriers as perceived by patients. J Obstet Gynaecol, 2006, 26(2): 144―148

doi: 10.1080/01443610500443527
Kapoor R, Sharma D K,Singh K J, Suri A, Singh P, Chaudhary H, Dubey D, Mandhani A. Sigmoid vaginoplasty: long-term results. Urology, 2006, 67(6): 1212―1215

doi: 10.1016/j.urology.2005.12.037
Fedele L, Bianchi S, Zanconato G, Raffaelli R. Laparoscopiccreation of a neovagina in patients with Rokitansky syndrome: analysisof 52 cases. Fertil Steril, 2000, 74(2): 384―389

doi: 10.1016/S0015-0282(00)00620-8
Bürger R A, Riedmiller H, Knapstein P G, Friedberg V, Hohenfellner R. Ileocecal vaginal construction. Am J Obstet Gynecol, 1989, 161(1): 162―167
Hendren W H, Atala A. Use of bowel for vaginalreconstruction. J Urol, 1994, 152(2 Pt 2): 752―755
Hensle T W, Reiley E A. Vaginal replacement in childrenand young adults. J Urol, 1998, 159(3): 1035―1038

doi: 10.1016/S0022-5347(01)63831-X
Khen-Dunlop N, Lortat-Jacob S, Thibaud E, Clément-Ziza M, Lyonnet S, Nihoul-Fekete C. Rokitansky syndrome: clinical experienceand results of sigmoid vaginoplasty in 23 young girls. J Urol, 2007, 177(3): 1107―1111

doi: 10.1016/j.juro.2006.11.003
Kwun Kim S, Hoon Park J, Cheol Lee K, Min Park J, Tae Kim J, Chan Kim M. Long-term results in patients after rectosigmoid vaginoplasty. Plast Reconstr Surg, 2003, 112(1): 143―151

doi: 10.1097/01.PRS.0000066169.78208.D4
El-Sayed H M, El-Lamie I K, Ibrahim A M, El-Lamie K I. Vaginal reconstruction with sigmoid colon in vaginal agenesis. Int Urogynecol J Pelvic Floor Dysfunct, 2007, 18(9): 1043―1047

doi: 10.1007/s00192-006-0287-3
Hensle T W, Shabsigh A, Shabsigh R, Reiley E A, Meyer-Bahlburg HF. Sexual functionfollowing bowel vaginoplasty. J Urol, 2006, 175(6): 2283―2286

doi: 10.1016/S0022-5347(06)00337-5
Darai E, Toullalan O, Besse O, Potiron L, Delga P. Anatomic and functional resultsof laparoscopic-perineal neovagina construction by sigmoid colpoplastyin women with Rokitansky’s syndrome. Hum Reprod, 2003, 18(11): 2454―2459

doi: 10.1093/humrep/deg443
Stelling J, Gray M, Davis A, van Lingen B, Reindollar R. Müllerian agenesis:an update. Obstet Gynecol, 1997, 90(6): 1024―1025
Maas S M, Eijsbouts Q A, Hage J J, Cuesta M A. Laparoscopic rectosigmoid colpopoiesis: does it benefit our transsexualpatients? Plast Reconstr Surg, 1999, 103(2): 518―524

doi: 10.1097/00006534-199902000-00023
Ohashi S, Ikuma K, Koyasu Y, Tei K, Kanno H, Akashi A, Haque S M. Laparoscopic reconstructionof vagina using sigmoid autograft. SurgEndosc, 1996, 10(10): 1019―1021

doi: 10.1007/s004649900228
Ling B, Sun M W, Sun F L, Zhang A J, Hu W P, Li J, Huang Q, Ning Z L. Study of operative procedures of laparoscopy and laparoscopicallyassisted sigmoid transplantation for vaginal construction. Zhonghua Fuchanke Zazhi, 2004, 39(5): 319―321 (in Chinese)
Rajimwale A, Furness P D 3rd, Brant W O, Koyle M A. Vaginal constructionusing sigmoid colon in children and young adults. BJU Int, 2004, 94(1): 115―119

doi: 10.1111/j.1464-4096.2004.04911.x
Parsons J K, Gearhart S L, Gearhart J P. Vaginal reconstruction utilizing sigmoid colon: Complicationsand long-term results. J Pediatr Surg, 2002, 37(4): 629―633

doi: 10.1053/jpsu.2002.31623
Cai B, Zhang J R, Xi X W, Yan Q, Wan X P. Laparoscopically assisted sigmoid colonvaginoplasty in women with Mayer-Rokitansky-Kuster-Hauser syndrome:feasibility and short-term results. BJOG, 2007, 114(12): 1486―1492

doi: 10.1111/j.1471-0528.2007.01514.x
[1] Junqing Wang, Lu Zhang, Weize Wu. Current progress on natural orifice transluminal endoscopic surgery (NOTES)[J]. Front Med, 2012, 6(2): 187-194.
[2] Jihui Ai, Pei Zhang, Lei Jin, Yufeng Li, Jing Yue, Ding Ma, Hanwang Zhang. Fertility outcome analysis after modified laparoscopic microsurgical tubal anastomosis[J]. Front Med, 2011, 5(3): 310-314.
[3] LU Bangyu, HUANG Yubin, CAI Xiaoyong, HUANG Fei, LU Wenqi, XU Jing, LIU Zujun, YAN Yihe, LI Jianjun, LI Jie. A novel method for reconstruction in laparoscopic pancreaticoduodenectomy: an experience of 13 cases[J]. Front. Med., 2007, 1(4): 369-372.
[4] JIANG Hongchi, ZHAO Xianqi, GAO Yue. Development of splenic surgery in China[J]. Front. Med., 2007, 1(2): 126-129.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed