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Study Objective To compare results of 3 original techniques of laparoscopically assisted colpopoiesis from the pelvic peritoneum. Design Prospective Level II study. Setting Department of Operative Gynecology, National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Healthcare of Russia. Patients or Participants We recruited 226 patients with utero-vaginal aplasia (MRKH). Interventions We used colpopoiesis from the peritoneum of the pelvis, developed by Adamyan, as a treatment method for patients with uterine and vaginal aplasia (MRKH). Since 2012, neovagina creation has been undertaken utilizing three different methods: laparoscopic-perineal technique, total laparoscopic technique, and combined laparoscopic-perineal technique with ligatures used to lower the peritoneum. Measurements and Main Results A total of 81 patients underwent colpopoiesis using the laparoscopic-perineal technique, employing in 105 cases a total laparoscopic colpopoiesis technique and in employing in 40 case a laparoscopic-perineal technique with ligatures. Rudimentary uterine horns were found in 37 patients. 18 percent had kidney dystopia, of which 12% had a pelvic kidney, and 10% had kidney aplasia. There were no significant differences between the three types of colpopoiesis in terms of blood loss, the duration of surgery, the length of stay in the postoperative hospital, and the use of painkillers in the postoperative period. In terms of complications, there was 1 case of bladder injury, and 1 case of rectal injury in patients with prior fibrosis was diagnosed and repaired during surgery. Postoperative neovaginal stricture was observed in 5 cases, and dyspareunia in 11 cases, which improved with the expansion of the vagina within 1 month. Conclusion Laparoscopy Involving neovagina creation is an effective and safe operation, even in patients with unsuccessful previous neovagina attempts and radiation-induced fibrosis, which provides sufficient length of neovagina of 10-12 сm, functional aspects such as lubrication, epithelialization, extensibility, and sensitivity. However, such interventions, especially in complex cases, should be provided only in specialized medical centers.

Congenital absence of vagina and uterus has been eponymously called Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. The vagina may appear as a dimple with the presence of rudimentary uterine primordia and normal functioning ovaries. Its incidence is 1 in 4500 to 5000 female. Patients present with primary amenorrhea, normal external genitalia, and well-developed secondary sexual characteristics. Davydov’s colpopoiesis is one of the methods of vaginoplasty using the patient’s own peritoneum as a graft to line the neovagina. We present here a case of MRKH Syndrome where a laparoscopic Davydov procedure was chosen for vaginal reconstruction.

For women with congenital vaginal agenesis and sexual needs, creating a functioning neovagina is a practical therapeutic schedule. Colpopoiesis using the sigmoid intestine were more reported in the literatures. Though the incidence of neovaginal prolapse (NP) is relatively low (3-8%), it does bring great inconvenience to patients, and expose gynecologists to tough challenges. Hereon, we report a case of NP 10 years after sigmoid colon vaginoplasty that was successfully repaired by laparoscopic sacro-colpopexy with a mesh, hoping to provide meaningful evidence for this rare situation.

Mayer–Rokitansky–Kuster–Hauser (M–R–K–H) syndrome is a rare congenital anomaly of the female genital tract. A number of techniques have been described for the formation of a neovagina, however, a standardized treatment does not yet exist. To evaluate three surgical procedures for colpopoiesis in patients with M–R–K–H syndrome, we design a retrospective study based on record of clinical data in our university hospital. Eighteen patients with M–R–K–H syndrome were performed colpopoiesis by Ruge's, McIndoe's, and laparoscopically assisted Davydov's procedures. We compare with three surgical procedures in terms of operative success rate, operation time, total bleeding loss during operation, perioperative complication rate, and long-term complications. The postoperative vaginal depth showed no significant difference among the three procedures. Operation success rate was 50.0% in Ruge's procedure, 88.9% in McIndoe's procedure, and 100% in laparoscopically assisted Davydov's procedure. The duration of McIndoe's ...

Background: Laparoscopic removal of a rudimentary uterus that has functional endometrium and colpopoiesis in a patient with Mayer-Rokitansky-Kuster-Hauser syndrome have been done at the same operation. Case: Removal of rudimentary uterus was relatively uncomplicated under laparoscopy. Colpopoiesis (creation of the neovagina with the modified Davydov's procedure) was possible after the resection procedure. Extraction of the rudimentary uterus via the neovagina during colopopoiesis was possible. Peritoneal denudation of the rudimentary uterus resection did not influence peritoneal suturing. Conclusions: The presence of peritoneal endometriosis was remarkable, especially in the apparent absence of an identifiable connection between the uterine cavity and fallopian tube. (J GYNECOL SURG 26:201)

BACKGROUND: Colpopoiesis using the sigmoid colon may be used in treatment of patients with Mayer-Rokitansky-Kuster-Hauser syndrome. Prolapse of a sigmoid neovagina is rare and its treatment is not yet standardized. CASES: Two patients developed severe prolapse of a neovagina derived from the sigmoid colon. One patient underwent resection of the redundant sigmoid and an abdominal suspension procedure; however, the prolapse has recurred. The other patient was treated by removal of the entire sigmoid artificial vagina. An alternative neovagina was reconstructed with a pudendal thigh flap. She has no signs of recurrent prolapse and is satisfied with sexual intercourse. CONCLUSION: Replacement therapy by a connected skin graft may be an excellent optional method as a radical treatment for prolapse of a sigmoid neovagina.

Purpose: We present a novel surgical treatment for secondary hematocolpos in adolescent girls with high vaginal atresia.Materials and Methods: Vaginoplasty was performed in 5 girls 12 to 14 years old with high vaginal atresia. The operation included the perineal approach, mobilization of hematocolpos and plastic surgery of the distal portion of the vagina using a U-shaped mucous-submucous vaginal flap, and introital and labial flaps.Results: There were no complications 4 to 6 months after the operation. There were no instances of cosmetic defects and stenosis.Conclusions: The proposed technique reduces the difficulty and trauma of the operation for high vaginal atresia with hematocolpos and an absent distal portion of the vagina. An increase in plastic reserve provided by the original mobilization of hematocolpos and U-shaped vaginal flap makes intestinal and skin colpopoiesis unnecessary.