Evaluation of vaginal agenesis treated with the modified McIndoe technique: A retrospective study

Karapınar, Oya Soylu; Özkan, Mustafa; Okyay, Ayşe Güler; Şahin, Hanifi; Dolapçıoğlu, Kenan

doi:10.5152/jtgga.2016.16013

Cited by 18 publications

(7 citation statements)

References 19 publications

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“…She was started on oestrogen and progesterone to develop other horn, however patient was lost to follow up. [1] In this study mean age of the patient was 28 years and most of them presented with primary amenorrhea or inability to have sexual intercourse.…”

Section: Resultsmentioning

confidence: 67%

A Comparative Analysis of Cryptomenorrhea in Patients with Vaginal Obstruction Vis a Vis Patients with Rudimentary non Communicating Horn of Uterus with Functional Endometrium: A Retrospective Study

Agarwal¹,

Pyrbot²,

Shullai³

2018

AIMDR

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Background: To analyse the clinical features, diagnostic challenge and treatment options in patients presenting with pain abdomen and cryptomenorrhea in patients with vaginal obstructive lesions in comparison with those having normal vagina but having non communicating rudimentary horn with functional endometrium. Methods: The clinical details of patients presenting with cryptomenorrhea to our institute was studied. The data collected was from a period of 7 years; from March 2010 to April 2017. The clinical details were collected from cases sheets of the respective cases. Result: A total of 6 cases were studied. Among the 6 patients, all were within the age group of 13-20 years. 3 patients had abnormality in the form of vaginal agenesis, transverse vaginal septum and imperforate hymen. All the 3 presented with amenorrhea and severe cyclical pain. The other 3 patients had rudimentary non communicating horn with functional endometrium and had different clinical presentations. One had severe dysmenorrhoea, one had severe cyclical pain with amenorrhea and the third patient had been operated earlier and presented with severe dysmenorrhoea with an incision site sinus with discharge of menstrual blood abdominally along with vaginal passage of menses. Since reflux of menstrual blood is seen in all cases, endometriotic ovary was found in 2 cases. One had only hematosalpinx. Two patients have been operated earlier for endometriotic cyst but the abnormality in the uterus or vagina was not detected, leading to reoccurrence of symptoms. Conclusion: Cryptomenorrhea or hidden menses due to congenital malformation in the uterus or vagina is a rare condition but can lead to distressing symptoms of dysmenorrhoea in young girls. It can also cause endometriosis due to retrograde menstruation .Improper evaluation can miss the proper diagnosis and patient may be operated only for endometriosis of ovary as a cause for dysmenorrhoea. Not identifying and treating the primary abnormality will lead to recurrence of symptoms and repeat surgeries in patients.

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Section: Resultsmentioning

confidence: 67%

A Comparative Analysis of Cryptomenorrhea in Patients with Vaginal Obstruction Vis a Vis Patients with Rudimentary non Communicating Horn of Uterus with Functional Endometrium: A Retrospective Study

Agarwal¹,

Pyrbot²,

Shullai³

2018

AIMDR

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“…The well-established techniques used for vaginoplasty include grafting with split-thickness skin [1–4], peritoneum [19], bowel, free jejunal autograft, ileum [20], or sigmoid colon [21]. The Vecchietti technique has been used as a less-invasive approach to surgical vaginoplasty or as modified technique of Brucker, Rall, and Wallwiener [5, 6] using vagino-abdominal blunt perforation without vesicorectal tunnelling.…”

Section: Discussionmentioning

confidence: 99%

“…Historically, the creation of a neovagina using a split-thickness skin graft and an inert prosthesis or synthetic mould to support the newly formed cavity (McIndoe’s technique) has been the most commonly performed vaginoplasty technique [1–4]. However, many other surgical procedures with different access pathways have also been performed (i.e., laparoscopic, laparotomic, vaginal, or combined procedures [5, 6]).…”

Section: Introductionmentioning

confidence: 99%

Clinical pilot study to evaluate the neovaginal PACIENA prosthesis® for vaginoplasty without skin grafts in women with vaginal agenesis

et al. 2019

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BackgroundTo evaluate the feasibility and clinical outcomes of vaginoplasties using a neovaginal polylactic acid prosthesis made with 3-dimensional (3D) printing technology as an intraneovaginal mould.MethodsThis was an interventionist, prospective, and multicentre clinical pilot investigation of a sanitary product (PACIENA prosthesis®) aiming to recruit and operate on 8 patients over 6 months with a follow-up period of 6 months. Only six patients with Rokitansky syndrome and one patient with Morris syndrome (7 patients in total) were operated on in two university hospitals: “La Fe”, Valencia (H1) and “Arrixaca”, Murcia (H2). Interventions: Extensive surgical dissection of a defined space between the urethra and bladder in the front and of the rectum in the back as well as insertion of the PACIENA prosthesis® covered with Interceed® were performed. After 12 days, the prosthesis was changed to the silicone-covered version for daily application.ResultsIn the 6 patients with Rokitansky syndrome (86%), the primary endpoint (satisfactory vaginal outcome in terms of appearance, function, and sensation without relevant additional morbidity) was achieved, although only 2 patients (28%) were sexually active at the end of 6 months of follow-up. The patient with Morris syndrome withdrew from the study after 1 month. Patients without bacterial colonization showed positive Schiller tests at 1 month, and subsequent biopsies showed adequate keratinization and epidermization. Epithelization and iodopositivity were delayed in the patients who developed inflammatory granulomas.ConclusionsGood anatomical and functional results can be achieved with the PACIENA prosthesis® for vaginoplasties without skin grafts. However, adequate patient selection and education, good surgical techniques and haemostasis, postoperative support, and prevention of bacterial colonization are important.Trial registrationThis clinical study was approved by the Ethical Clinical Investigation Committee of San Juan University Hospital on September 27, 2016, to be conducted in the participating centres; it was authorized by the Spanish Agency of Medicines and Health Products (AEMPS) on April 24, 2017 (exp. no. 585/16/EC), to be carried out in that hospitals.

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“…Vaginal atresia, a rare Müllerian anomaly, with an incidence of 1/4000 to 1/10000 persons, is frequently characterized by a normal lower vagina or the absence of a vagina. [ 1 ] Vaginal atresia can present as distal or total vaginal atresia, and in the latter case, the uterus always has an anatomically normal corpus and cervical aplasia, except in sporadic patients, in whom a rudimentary horn accompanies the uterus. [ 2 , 3 ] The case described herein is a new female genital anomaly with a combination of vaginal atresia and cervical agenesis with septate uterus.…”

Section: Introductionmentioning

confidence: 99%

Vaginal atresia and cervical agenesis combined with asymmetric septate uterus

Han

Chen²,

Wang³

et al. 2018

Medicine

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Rationale:A combination of Vaginal atresia and septate uterus as a novel genital malformation has been reported the first time. It offers a support for the bidirectional theory.Patient concerns:A 23-year-old woman presented with the inability to perform intercourse. The unprecedented variant was misdiagnosed by magnetic resonance imaging and ultrasonography as low vaginal atresia associated with complete septate uterus with functional endometrium in both the cavities.Diagnoses:The correct diagnosis was made and confirmed intraoperatively as a genital malformation, vaginal atresia and cervical agenesis associated with septate uterus.Intervention:laparoscopic and hysteroscopic diagnosis the novel malformation never been reported and a vaginal stent was recommended postoperatively.Outcomes:This rare clinical variant made misdiagnosis. Intraoperatively, unprecedented genital malformation was confirmed. There are no vaginal atresia cases in the literature with a septate functional uterus and single agenesis cervix.Lessons:Confirmed diagnosed by operation instead of depending on the imaging should be used for rare genital anomaly.

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Evaluation of vaginal agenesis treated with the modified McIndoe technique: A retrospective study

Abstract: Conclusion:Although there is no consensus about the ideal method of making a functioning vagina among different specialties.

Cited by 18 publications

References 19 publications

A Comparative Analysis of Cryptomenorrhea in Patients with Vaginal Obstruction Vis a Vis Patients with Rudimentary non Communicating Horn of Uterus with Functional Endometrium: A Retrospective Study

A Comparative Analysis of Cryptomenorrhea in Patients with Vaginal Obstruction Vis a Vis Patients with Rudimentary non Communicating Horn of Uterus with Functional Endometrium: A Retrospective Study

Clinical pilot study to evaluate the neovaginal PACIENA prosthesis® for vaginoplasty without skin grafts in women with vaginal agenesis

Vaginal atresia and cervical agenesis combined with asymmetric septate uterus

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