Creation of a neovagina after Creatsas modification of Williams vaginoplasty for the treatment of 200 patients with Mayer-Rokitansky-Kuster-Hauser syndrome

Mullerian dysgenesis: a critical review of the literature

“…In the past years, however, the procedure-in the modified form-has been used as a primary method for surgical reconstruction with promising results [143][144][145][146]. The original procedure consists of four main steps.…”

“…Many modifications of the Williams technique have been described from various surgeons with satisfactory results [147][148][149]. Creatsas modification of Williams vaginoplasty is one of the most effective methods, reporting the creation of a functional neovagina in 191 out of 200 patients (95.5%) and only eight postoperative wound openings (4%) [145]. Quality of sexual life was reported as 'satisfactory' by 189 patients (94.5%), 'adequate' by 10 patients (5%), and 'unsatisfactory' by only one woman (0.5%) [136,145].…”

“…Creatsas modification of Williams vaginoplasty is one of the most effective methods, reporting the creation of a functional neovagina in 191 out of 200 patients (95.5%) and only eight postoperative wound openings (4%) [145]. Quality of sexual life was reported as 'satisfactory' by 189 patients (94.5%), 'adequate' by 10 patients (5%), and 'unsatisfactory' by only one woman (0.5%) [136,145]. Mean surgical time was 28 min (range 24-43 min), while mean hospital stay was 6 days (range 3-11 days) [145].…”

“…Quality of sexual life was reported as 'satisfactory' by 189 patients (94.5%), 'adequate' by 10 patients (5%), and 'unsatisfactory' by only one woman (0.5%) [136,145]. Mean surgical time was 28 min (range 24-43 min), while mean hospital stay was 6 days (range 3-11 days) [145]. The main differences of Creatsas modification from the classic Williams vaginoplasty are the cutting of the hymen at the beginning of the procedure and the use of absorbable sutures, such as Dexon or Vicryl, for all the tissue layers [143,144].…”

Pathophysiology and Clinical Assessment of Primary Amenorrhea

“…DP is also the absence of menstruation in 13-14-year-old girls who have no secondary sexual characteristic development. The causes of DP are (1) general: constitutional delay of growth and puberty, underweight, and other chronic diseases; (2) gonadal origin (hypergonadotropic hypogonadism): prodromal premature ovarian failure-karyotypically normal, Turner's syndrome, and pure gonadal dysgenesis; (3) autoimmune oophoritis; (4) 17,20-desmolase deficiency; (5) radiation or chemotherapy; (6) FSH receptor mutation; (7) galactosemia; (8) congenital hypogonadotropic hypogonadism; (9) gonadotropin deficiency; and (10) hypothalamic/pituitary lesions [3,5,[11][12][13][14].…”