Role of estrogen receptor alpha on vaginal epithelialization of patients with Mayer–Rokitansky–Kuster–Hauser syndrome submitted to neovaginoplasty using oxidized regenerated cellulose

Abstract

In our study, the expression of ERα occurred when complete epithelialization of vaginal tissue was observed. Other mechanisms may be involved in the formation of vaginal epithelium in patients with MRKH syndrome.

Treatment for vaginal agenesis: A prospective and comparative study between vaginal dilation and surgical neovaginoplasty

“…Whereas Callens et al 25 used abdominal routes, the Vecchietti and Davydov techniques, the technique mostly used at this medical service is the modified Abbé-McIndoe technique (Figure 1), with oxidized cellulose, which involves a shorter operating time and less pain and discomfort. [13][14][15][16] Neovaginas created with this technique have hormone receptors and histopathologic aspects similar to those observed in a natural vagina. [13][14][15][16] This may be the reason why Callen et al 25 In cases in which surgical intervention is required, referrals to centers with expertise in this area should be considered because few surgeons have extensive experience in construction of the neovagina and surgery by a trained surgeon offers the best opportunity for a successful result.…”

“…The FSFI was applied between 3 and 6 months of follow‐up, only once per patient. Anatomical success was defined as a TVL longer than 6 cm, which allowed the easy introduction of two fingers, based on previous studies conducted in the same hospital 13‐16 …”

“…The patients underwent the modified Abbé-McIndoe technique with oxidized regenerated cellulose. [13][14][15][16] A transversal incision was made in the area of the vaginal dimple and a tunnel was bluntly created up to a vaginal length of 8-9 cm. In three cases, the puborectalis muscle had to be incised to expand the vaginal amplitude.…”

Study and evaluation of neovagina epithelium

“…After 5 months, collagen content was comparable to that of a normal vagina. Kajikawa et al (2012) performed immunohistochemical evaluation of the expression of estrogen receptor alpha on neovaginal tissue of patients with vaginal agenesis (Mayer-Rokitansky-Kuster-Hauser Syndrome) in serial samples obtained after surgery. A total of 22 samples of neovaginal tissue was analyzed in 3 groups and the ER alpha expression after 2, 3, 5 and 6 months of surgery.…”

Interceed and Estrogen Reduce Uterine Adhesions and Fibrosis and Improve Endometrial Receptivity in a Rabbit Model of Intrauterine Adhesions

“…20 Interceed is a lightweight, tissue-like ''fabric'' that can be placed at the surgical site and has been used for prevention of adhesions in a variety of gynecologic pelvic surgical procedures. 21 Interceed was also used to reduce postoperative adhesions in the neovagina, [22][23][24] breast, 25,26 and trachea. 27 However, few studies have investigated the antiadhesive effect of Interceed within the uterine cavity, except one study reporting that Interceed plus preoperative gonadotropin-releasing hormone agonist could reduce IUAs in the rabbit after various surgical manipulations in uterine horns.…”