Back to Search
Start Over
Neovagina Creation: A Novel Improved Laparoscopic Vecchietti Procedure in Patients with Mayer-Rokitansky-Küster-Hauster Syndrome.
- Source :
-
Journal of minimally invasive gynecology [J Minim Invasive Gynecol] 2021 Jan; Vol. 28 (1), pp. 82-92. Date of Electronic Publication: 2020 Apr 10. - Publication Year :
- 2021
-
Abstract
- Study Objective: To report a new improved laparoscopic Vecchietti vaginoplasty in patients with congenital vaginal agenesis and to investigate its efficacy and safety.<br />Design: A retrospective descriptive and case-control study.<br />Setting: Single academic institution.<br />Patients: Women who were diagnosed with Mayer-Rokitansky-Küster-Hauster (MRKH) syndrome and underwent our new improved laparoscopic Vecchietti procedure from July 2010 to June 2019 were selected as the study group. The eligible participants had congenital vaginal agenesis with normal 46,XX karyotype and ovarian function. Age-matched, nulliparous, sexually active women were selected as the control group.<br />Interventions: Women with MRKH syndrome in the study group underwent the novel improved laparoscopic Vecchietti procedure. All participants in both groups were required to complete Female Sexual Function Index and Female Genital Self-Image Scale questionnaires.<br />Measurements and Main Results: The effects of our procedure, including the anatomic and functional efficacy of the neovagina, were the primary outcomes. The secondary outcomes consisted of the perioperative complications, surgical morbidities, and long-term postoperative discomfort. A total of 79 patients with MRKH syndrome underwent our new improved Vecchietti vaginoplasty, of whom 44 (55.7%) were diagnosed as Type I MRKH syndrome, whereas 35 (44.3%) were Type II MRKH syndrome. At a 30-month follow-up after surgery, an anatomic neovagina measuring 10.44 cm in length and 1.30 cm in width was achieved. All 79 patients obtained anatomic success with 92.41% of functional efficacy. Compared with 81 age-matched, nulliparous women in the control group, there was no statistical difference regardless of individual measure or total Female Sexual Function Index scores (p >.05). The Female Genital Self-Image Scale assessment showed a significantly lower score in patients undergoing the vaginoplasty (20.14 ± 3.05 vs 22.95 ± 2.12; p <.001). There were no severe perioperative complications except 1 mild bladder injury and 1 transient fever.<br />Conclusion: Our novel improved laparoscopic Vecchietti vaginoplasty is a relatively safe and effective method for surgical treatment of congenital vaginal agenesis. It may be an alternative to neovagina creation for reaching satisfying anatomic and functional efficacy and improving patients' sexual function.<br /> (Copyright © 2020 AAGL. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- 46, XX Disorders of Sex Development epidemiology
46, XX Disorders of Sex Development pathology
Adolescent
Adult
Case-Control Studies
China epidemiology
Congenital Abnormalities epidemiology
Congenital Abnormalities pathology
Female
Humans
Inventions
Mullerian Ducts pathology
Mullerian Ducts surgery
Postoperative Complications epidemiology
Retrospective Studies
Self Concept
Sexual Dysfunction, Physiological epidemiology
Sexual Dysfunction, Physiological etiology
Therapies, Investigational methods
Treatment Outcome
Vagina abnormalities
Vagina pathology
Young Adult
46, XX Disorders of Sex Development surgery
Congenital Abnormalities surgery
Gynecologic Surgical Procedures methods
Laparoscopy methods
Mullerian Ducts abnormalities
Plastic Surgery Procedures methods
Surgically-Created Structures pathology
Vagina surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1553-4669
- Volume :
- 28
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of minimally invasive gynecology
- Publication Type :
- Academic Journal
- Accession number :
- 32283327
- Full Text :
- https://doi.org/10.1016/j.jmig.2020.04.006