Treatment of vaginal agenesis with modified Abbé–McIndoe technique: long-term follow-up in 22 patients

Keser, Abdulmuttalip; Bozkurt, Nuray; Taner, Ömer Faruk; Şensöz, Ömer

doi:10.1016/j.ejogrb.2004.11.027

Cited by 27 publications

(10 citation statements)

References 15 publications

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“…The main disadvantages of this procedure are the visible scar, including keloids and infection [Seccia et al, 2002;Klingele et al, 2003], inadequate lubrication and high rate of graft stenosis necessitating frequent and potentially life long dilation. Long-term sexual function results have not been validated; however, sexual satisfaction rates have been reported to be between 80 and 90% [Mobus et al, 1996;Keser et al, 2005].…”

Section: Skin Graftsmentioning

confidence: 99%

Management of Vaginal Hypoplasia in Disorders of Sexual Development: Surgical and Non-Surgical Options

Deans

Berra²,

Creighton³

2010

Sex Dev

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Patients with disorders of sexual development (DSD) requiring vaginal reconstruction are complex and varied in their presentation. Enlargement procedures for vaginal hypoplasia include self-dilation therapy or surgical vaginoplasty. There are many vaginoplasty techniques described, and each method has different risks and benefits. Reviewing the literature on management options for vaginal hypoplasia, the results show a number of techniques available for the creation of a neovagina. Studies are difficult to compare due to their heterogeneity, and the indications for surgery are not always clear. Psychological support improves outcomes. There is a paucity of evidence to inform management regarding the optimum surgical technique to use, and long-term data on success is lacking, particularly with respect to sexual function. In conclusion, vaginal dilators remain the cornerstone of treatment of women with vaginal hypoplasia and should be used as the first-line technique. Surgical vaginoplasty has a role in complex patients with previous failed dilation and surgical intervention, particularly those cases where there is significant scarring from previous surgery. Regardless of the vaginal reconstruction technique, patients should be managed in a multidisciplinary team where there is adequate emotional and psychological support available.

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Section: Skin Graftsmentioning

confidence: 99%

Management of Vaginal Hypoplasia in Disorders of Sexual Development: Surgical and Non-Surgical Options

Deans

Berra²,

Creighton³

2010

Sex Dev

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“…The main disadvantages of this technique are the association with significant skin graft contracture, developing of fistulas, visible scar formation at the donor site with possibility of poor aesthetic results, and the high costs due to involvement of a plastic surgery team and long hospitalization. 33 The use of an isolated segment of sigmoid colon for neovagina creation has been reported to yield satisfactory anatomic and functional outcomes. [34][35][36] It is a more complex procedure, but has a low risk of neovaginal stenosis and dispenses with the use of postoperative vaginal dilatation.…”

Section: Discussionmentioning

confidence: 99%

Creation of a Neovagina by Laparoscopic Modified Vecchietti Technique: Anatomic and Functional Results

Baptista

Carvalho

Nobre

et al. 2016

Rev Bras Ginecol Obstet

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Keywords► laparoscopy ► gynecologic surgery ► minimally invasive surgery ► mayer-rokitanskyküster-hauser syndrome ► androgen insensitivity syndrome ► sexuality AbstractPurpose To evaluate the anatomic and functional results of a laparoscopic modified Vecchietti technique for the creation of a neovagina in patients with congenital vaginal aplasia. Methods Retrospective study of nine patients with congenital vaginal aplasia submitted to the laparoscopic Vecchietti procedure, in our department, between 2006 and 2013. The anatomical results were evaluated by assessing the length, width and epithelialization of the neovagina at the postoperative visits. The functional outcome was evaluated using the Rosen Female Sexual Function Index (FSFI) questionnaire and comparing the patients' results to those of a control group of 20 healthy women. The statistical analysis was performed using SPSS Statistics version 19.0 (IBM, Armonk, NY, USA), Student t-test, Mann-Whitney U test and Fisher exact test. Results The condition underlying the vaginal aplasia was Mayer-Rokitansky-Küster-Hauser syndrome in eight cases, and androgen insensitivity syndrome in one case. The average preoperative vaginal length was 2.9 cm. At surgery, the mean age of the patients was 22.2 years. The surgery was performed successfully in all patients and no intra or postoperative complications were recorded. At the first postoperative visit (6 to 8 weeks after surgery), the mean vaginal length was 8.1 cm. In all cases, the neovagina was epithelialized and had an appropriate width. The mean FSFI total and single domain scores did not differ significantly from those of the control group: 27.5 vs. 30.6 (total); 4.0 vs. 4.2 (desire); 4.4 vs. 5.2 (arousal); 5.2 vs. 5.3 (lubrication); 4.2 vs. 5.0 (orgasm); 5.3 vs. 5.5 (satisfaction) and 4.4 vs. 5.4 (comfort). Conclusions This modified laparoscopic Vecchietti technique is a simple, safe and effective procedure, which allows patients with congenital vaginal aplasia to have a satisfactory sexual activity, comparable to that of normal controls.

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“…The ideal procedure has been elusive, and there are differences of opinion among various authorities concerning the techniques 5,12,13 . A number of operative procedures have been advocated for creation of the neovagina, including insertion of a skin-covered vaginal mold(Abbe-McIndoe procedure), various fasciocutaneous and myocutaneous flaps vulvovaginal flap, labial flaps using tissue expanders, full thickness skin grafts with vacuum-assisted wound closure and use of amnion and peritoneum [14][15][16][17][18][19][20][21][22][23][24] . There are some recent reports of laparoscopic approach to fashion a neovagina with peritoneum 25 .…”

Section: Discussionmentioning

confidence: 99%

Mayer-Rokitansky-Kuster-Hauser (MRKH) Syndrome A Case ReportRT

Islam

Alam

Hanif

et al. 2014

J. paediatr. surg. Bangladesh

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Abstract:We report a case of Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome in a 25 year old married lady. Though it is a congenital abnormality, she presented as primary infertility after 2 year of her marriage and was referred to us from a Gynaecologist. She had absent vagina, rudimentary uterus with no cervix. Her ovaries were severely hypoplastic. The anus was placed anteriorly and opened into the vulva. In spite of absence of her vagina, the lady somehow maintained her married life by doing intercourse through the anteriorly placed rectum. The vagina was made from the lower end of existing rectum which opened into the vulva. The proximal end of the rectum and left colon were pulled through the pelvis and opened into the perineum. It improved her quality of life.

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Treatment of vaginal agenesis with modified Abbé–McIndoe technique: long-term follow-up in 22 patients

Cited by 27 publications

References 15 publications

Management of Vaginal Hypoplasia in Disorders of Sexual Development: Surgical and Non-Surgical Options

Management of Vaginal Hypoplasia in Disorders of Sexual Development: Surgical and Non-Surgical Options

Creation of a Neovagina by Laparoscopic Modified Vecchietti Technique: Anatomic and Functional Results

Mayer-Rokitansky-Kuster-Hauser (MRKH) Syndrome A Case ReportRT

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Treatment of vaginal agenesis with modified Abbé–McIndoe technique: long-term follow-up in 22 patients

Cited by 27 publications

References 15 publications

Management of Vaginal Hypoplasia in Disorders of Sexual Development: Surgical and Non-Surgical Options

Management of Vaginal Hypoplasia in Disorders of Sexual Development: Surgical and Non-Surgical Options

Creation of a Neovagina by Laparoscopic Modified Vecchietti Technique: Anatomic and Functional Results

Mayer-Rokitansky-Kuster-Hauser (MRKH) Syndrome  A Case ReportRT

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Mayer-Rokitansky-Kuster-Hauser (MRKH) Syndrome A Case ReportRT