Comparative Study of Creation of Neovagina Using Skin Graft and Interceed in Mayer–Rokitansky–Küster–Hauser Syndrome

Abstract

Objective: This study compared and evaluated the outcomes of using Interceed and skin graft in vaginoplasty for women with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome on the basis of vaginal length (neovagina), procedure safety, patient satisfaction (sexual) after marriage, ease of procedure, procedure time, and morbidity. Materials and Method: Over the course of 18 months, this hospital-based randomized controlled trial was conducted at a tertiary care center. There were 17 women with primary amenorrhea and MRKH syndrome who had undergone vaginoplasty and met the inclusion and exclusion criteria. Nine women received vaginoplasty with Interceed and eight women got vaginoplasty with skin graft, and they were monitored for 6 months postmarriage using a computerized block randomization system. Anatomical and functional outcomes were assessed in these women. The percentage, mean, and standard deviation (SD) were calculated using Epi Info program. For the analysis, the Mann-Whitney and Fischer tests were used. Observations: Women in group A (Interceed) were 22.322 ± 1.59 years old, whereas those in group B (split-thickness skin transplant) were 23.85 ± 1.83 years old. On day 8, the length of the vagina in women who had vaginoplasty with Interceed (Group A) was 8.8330.4153 cm, which was longer than 8.413 ± 0.4190 cm in women who had split-thickness skin transplant (Group B). The vaginal width was determined to be two-finger breadth in both groups. The duration of surgery in women undergoing vaginoplasty with Interceed (Group A) was 32 ± 4.243 minutes as compared to split-thickness skin graft (Group B) where it was 61.38 ± 8.634 minutes. This difference is statistically significant. The functional outcome in relation to sexual satisfaction (lubrication, orgasm, satisfaction, and pain) in women undergoing vaginoplasty with Interceed was 77.8% as compared to 37.5% with Split-thickness skin graft. Conclusion: By using Interceed for vaginoplasty, gynecologist is independent and no separate procedure is required for graft. It is safe, easy, effective, less time-consuming and patient satisfaction with anatomical and functional outcome is good due to squamous epithelization. Hence, is a potential alternative for vaginal agenesis.

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“…Vaginoplasty by different surgical methods seems to have the highest anatomical (99%) and functional (96 %) success rates 6 . If needed surgical procedures are often advised to patients three to six months prior to marriage 7 . Correction of the congenital anomaly along with psychosocial counselling remains the cornerstone for maximum efficacy of treatment.…”