Vaginal Reconstruction in Patients with Mayer–Rokitansky–Küster–Hauser Syndrome—One Centre Experience

Abstract

<jats:p>Background and Objectives: The Mayer–Rokitansky–Küster–Hauser syndrome is a congenital condition in which patients are born with vaginal and uterus agenesis, affecting the ability to have a normal sexual life and to bear children. Vaginal reconstruction is a challenging procedure for plastic surgeons. The aim of this study is to report our experience in the management of twelve patients with congenital absence of the vagina due to the MRKH syndrome. Materials and Methods: We performed a retrospective study on 12 patients admitted to the Plastic Surgery Department of the Clinical Emergency Hospital “Prof. Dr. Agrippa Ionescu”, Bucharest, Romania, for vaginal reconstruction within a period of eleven years (January 2009–December 2019). All patients were diagnosed by the gynaecologists with vaginal agenesis, as part of the Mayer–Rokitansky–Küster–Hauser syndrome. The Abbe‘–McIndoe technique with an autologous skin graft was performed in all cases. Results: The average age of our patients was 20.16 (16–28) years. All patients were 46 XX. The average surgical timing was 3.05 h (range 2.85–4h). Postoperative rectovaginal fistula was encountered in 1 patient. Postoperative average vaginal length was 10.4 cm (range 9.8–12.1 cm). Regular sexual life was achieved in 10 patients. Conclusion: Nowadays, there is no established standard method of vaginal reconstruction. In Romania, the McIndoe technique is the most applied. Unfortunately, even if the MRKH syndrome is not uncommon, less and less surgeons are willing to perform the procedure to create a neovagina.</jats:p>

Satisfactory Outcome of Various Novel Modified Laparoscopic Neovaginoplasty Using Autologous Peritoneal Graft

“…Other estimates say 1 in 4000–20,000. [ 1 2 ] The etiology of MRKH syndrome is still unclear. [ 1 ] From the genetic aspect, MRKH syndrome is known to have familial cases in the form of autosomal dominant.…”

“…Patients usually have normal reproductive endocrine function and show normal signs of thelarche and pubarche. [ 1 2 ] There are two types of MRKH syndrome: the first is characterized by the absence of the proximal (2/3) of the vagina and agenesis of the uterus with normal development of the renal and ovarian systems. This type is found in 44% of cases of MRKH syndrome.…”

Single-Center Oncologic Outcome of Fat Transfer for Breast Reconstruction Following Mastectomy in 1000 Cancer Cases – A Matched Case-Control Study

“…13 Nowadays, no one questions how breast reconstruction improves psychological well-being and quality of life of women facing breast cancer. 14–16 Thankfully, as time went on, research evolved demonstrating the overwhelming safety of breast reconstruction, which is now routine practice and a necessary medical procedure in the United States since 1998, with passage of the Women’s Health and Cancer Rights Act. 17 Nevertheless, with surgical advancements and the implementation of new technologies, attention is now being directed toward autologous fat transfer as a possible culprit for local recurrence.…”

“…13 Nowadays, no one questions how breast reconstruction improves psychological well-being and quality of life of women facing breast cancer. [14][15][16] Thankfully, as time went on, research evolved demonstrating the overwhelming safety of breast reconstruction, which is now routine practice and a necessary medical procedure in the United States since 1998, with passage of the Women's Health and Cancer Rights Act. 17…”

Mayer-Rokitansky-Küster-Hauser syndrome - a review based on recent advances in medicine

“…Następnie w utworzoną przestrzeń umieszcza się plastyczny rozszerzacz, zabezpieczając go szwami na wargach sromowych. Rozszerzacz i szwy utrzymuje się do 14 dni po zabiegu [3,20,23]. Istnieją wysokie wskaźniki sukcesu anatomicznego i funkcjonalnego (83-96%) [24].…”