Sexuality and Psychosocial Functioning in Young Women After Colovaginoplasty

Abstract

Based on the scoring system outcome colovaginoplasty seems to be an excellent choice to manage vaginal agenesis and ensure good quality of general and sexual life.

Non-Obstructive Müllerian Anomalies

“…Hysteroscopic metroplasty for uterine septae has been shown to significantly improve reproductive performance in women undergoing assisted reproduction as well as those with previous recurrent pregnancy loss. 39,40,51,55,56 Caring for women with vaginal agenesis and other uterine and vaginal anomalies should be done in centers with interdisciplinary expertise in attending to all the psychological, surgical and medical expertise.…”

“…40 The intestinal vaginoplasty can provide a reliable option for those patients who have been unable to dilate and maintain a neovagina created by other methods. Sigmoid colon can readily be mobilized on a vascular pedicle and transposed into the pelvis as a neovagina and is most commonly used.…”

“…One of the main advantages is that postoperative dilation is not necessary. 40 Using a segment of intestine as a vaginal graft, either in open surgery or now as a laparoscopic procedure, obviously represents a much more invasive surgical procedure, with different risks of complications, including abdominal adhesions and stricture of the introital site. Because of this, it is generally reserved for patients without options for nonsurgical dilatation or other types of surgical neovagina creation (ie, no vaginal perineal skin that would respond to dilators) as well as those who have failed other vaginoplasty procedures.…”

Vaginal agenesis or distal vaginal atresia associated with anorectal malformations

“…The short-term cosmetic outcome was very good. In patients with MRKH syndrome and normal anus, several follow-up studies have shown that colovaginoplasty is an acceptable option for replacement of the vagina [21,22]. Hensle et al [21] showed that 78% of 36 patients who were evaluated reported sexual satisfaction after bowel vaginoplasty.…”

Colonic Adenocarcinoma of a Neovagina in a Patient with Mullerian Agenesis

“…After gonadal dysgenesis, MRKH is the second most common cause of primary amenorrhea [2]. Nonsurgical vaginal dilation or surgical creation of a neovagina are among the treatment options, and allow for normal sexual intercourse [3,4].…”