Cervicovaginal atresia with hematometra: restoring menstrual and sexual function by utero-coloneovaginoplasty

Abstract

Patients with cervicovaginal atresia need to be counselled about the various reconstructive options available and the potential risks. Social and economic factor play a significant role in determining the plan of management. For patients from conservative societies, utero-coloneovaginoplasty provides a safe conduit for the passage of menstrual flow and coitus, at the cost of permanent infertility.

Bowel vaginoplasty in children and young women: an institutional experience with 55 patients

“…Patients with MRKH have vaginal atresia with varying degrees of uterine hypoplasia, while patients with cervicovaginal atresia have vaginal and cervical atresia with a normally functioning uterine fundus [17]. About 10 % of patients with MRKH have functioning endometrium [19]. The patient in our study with cervical atresia had undergone several failed previous attempts at canalisation.…”

“…Many patients cannot afford more than a single definitive procedure. Further, ours is a conservative society where the loss of the vagina and fertility makes it very unlikely for the patient to get married [19]. The utero-coloneovaginoplasty, described earlier by Kanniayan and Sen, is tailored to meet this need-ensuring a safe, wide, epithelially lined, lubricated conduit for menses and coitus, at the cost of infertility [4].…”

“…The utero-coloneovaginoplasty, described earlier by Kanniayan and Sen, is tailored to meet this need-ensuring a safe, wide, epithelially lined, lubricated conduit for menses and coitus, at the cost of infertility [4]. The wide anastomosis provides free drainage of the menstrual blood, thus preventing haematometra and pyometra [4,19]. We have performed utero-coloneovaginoplasty on 30 patients (cervicovaginal atresia, n=20, MRKH, n=9, cervical atresia, n=1).…”

Neovagina creation using sigmoid colon in vaginal agenesis: a case report and review of literature

“…Initially canalization procedures were performed which if unsuccessful were treated with hysterectomy Patients who have functional uterus, Colo vaginoplasty is also a safe procedure. 2,5,7,9,10 The creation of a neovagina and uterine opening anastomosis should be done at around age of 10-12 years to avoid endometriosis. 10 Many surgical options for vaginal substitution have been described, with the split-thickness skin graft vaginoplasty for patients with agenesis.…”

“…Tension over the harvested vascular pedicle, short mesentery, masculinized pelvis and obesity are some of the challenges. These can be overcome by using the techniques employed by 2,6,10 Thus more patients treated with this technique need to be evaluated for comparing immediate, late and long term outcomes. 16,17 Authors created the neovagina using the sigmoid colon segment and anastomosed it in a single sitting, unlike the two staged technique as described by Yang-Monti.…”