Changes in Squamous Epithelium Following the Surgical Treatment of Absence of the Vagina

Whitacre, Frank E.; Alden, Roland H.

doi:10.1097/00006254-195112000-00065

Cited by 5 publications

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“…In contrast, after skin grafts, most cytologic and histologic reports, with some cases followed for more than 20 years, have shown that the neovaginal epithelium does not completely lose its original histologic nature and retains the features of keratinizing squamous epithelium since there is persistence of extensive keratinization. 11,13,17,20,22,26 However, a few cases, all with follow-up of > 10 years, have shown a decrease in keratinization, probably because in the new environment the stratum corneum is not subjected to stimuli, such as pressure and abrasions. 11,13 Primary carcinoma arising in artificial vaginas 3-19 years after vaginal reconstruction have been reported: squamous cell carcinoma after skin grafts 3,9,15,18,19,25 and adenocarcinoma after vaginal reconstruction with tissue from the small intestine.…”

Section: Discussionmentioning

confidence: 99%

Cytologic Findings in a Neovagina Created with Vecchietti’s Technique for Treating Vaginal Aplasia

Belleannée¹,

Brun²,

Trouette³

et al. 1998

Acta Cytologica

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Section: Discussionmentioning

confidence: 99%

Cytologic Findings in a Neovagina Created with Vecchietti’s Technique for Treating Vaginal Aplasia

Belleannée¹,

Brun²,

Trouette³

et al. 1998

Acta Cytologica

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“…ureteric reconstruction in the dog, using a skin graft, resulted in metaplasia of the stratified nonsquamous epithelium into urothelium [24]. The split‐skin graft used in the McIndoe technique also changes into stratified but squamous epithelium, and keratinization persists in most patients with different intensities [24–27]. This might be the cause of inadequate moistening during intercourse and the need for lubrication.…”

Section: Discussionmentioning

confidence: 99%

Twenty years of experience with Krzeski’s cystovaginoplasty for vaginal agenesis in Mayer‐Rokitansky‐Küster–Hauser syndrome: anatomical, histological, cytological and functional results

2008

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RESULTSThe anatomical result was good in 37 patients during a mean (range) follow-up of 9 (0.25-19) years; the result was good in 30 patients, but seven developed vaginal stenosis that was successfully repaired. There were two cases of post-coital vesicovaginal fistula (VVF) at 18 months after CVP. Vaginal biopsies showed epithelialization of the posterior vaginal wall and gradual metaplastic changes from urothelium to stratified nonsquamous epithelium. Cytological smears showed a normal biphasic pattern and neovaginal susceptibility to hormonal milieu. In all, 27 patients (73%) responded to the questionnaire. All had sexual partners and started sexual intercourse at a mean of 14 months after CVP; 89% experience orgasms and in 48% the vagina was the source; 40% sometimes used lubricants and seven (26%) used vaginal dilators. Lower urinary tract symptoms (LUTS) after CVP were reported by 19 (66%) of the women and in six the LUTS were persistent. One patient was not satisfied with the functional and anatomical result of CVP, 89% declared that it improved sexual life, 93% would undergo CVP again and in 92% the quality of their sexual life was improved. All patients, when asked, stated that they would recommend CVP to another patient with MRKHS. CONCLUSIONSVaginal reconstruction by CVP is characterized by good anatomical and functional results, sustained by long-term observation. The resultant epithelium is very similar to that of the native vagina in histology and function. All vaginas are functional and the level of patient satisfaction was high. The level of complications was acceptable, but in some patients LUTS can persist. KEYWORDS PATIENTS AND METHODSBetween 1981 and 2000, 38 patients (mean age 22.5 years, range 18-40) with MRKHS underwent CVP. A physical examination was used to evaluate the anatomical results, 27 patients had vaginography, and biopsies of the neovaginal wall and cytohormonal smears were taken in two. Functional sexual and urinary results, and opinions on CVP, were evaluated by an inventory mailed to 37 patients in 2000.

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“…Regardless of the tissues utilized in the formation of the neovagina, vulnerability to environmental conditions remains a serious concern for both patients and physicians. It has been reported [6] that transplanted or transposed tissues retain their original characteristics. As such, it is also plausible that the same characteristics can be applied to their oncological potential as well.…”

Section: Discussionmentioning

confidence: 99%

Cancer of the Urinary Bladder Neovagina in a Patient with Morris’ Syndrome

et al. 2008

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Background: Vaginal agenesis is a rare condition, therefore the incidence of a malignant transformation in the neovagina is extremely low. Case Report: We report on a 42-year-old patient with Morris’ syndrome and urinary bladder neovagina with a history of prolonged infections of the urinary bladder and intertrigo of the perineal region. The biopsy revealed a squamous cell carcinoma arising from the neovagina. The patient underwent combined radio- and chemotherapy and was disqualified from surgical treatment because of the advanced stage of the disease. Conclusions: Because of the high risk of malignant transformations regular follow-ups are necessary in patients with neovagina creation, including gynecological examination, cytological screening, and biopsy if necessary. In addition, urinary bladder does not seem to be a good material for a functional vagina.

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Changes in Squamous Epithelium Following the Surgical Treatment of Absence of the Vagina

Cited by 5 publications

References 0 publications

Cytologic Findings in a Neovagina Created with Vecchietti’s Technique for Treating Vaginal Aplasia

Cytologic Findings in a Neovagina Created with Vecchietti’s Technique for Treating Vaginal Aplasia

Twenty years of experience with Krzeski’s cystovaginoplasty for vaginal agenesis in Mayer‐Rokitansky‐Küster–Hauser syndrome: anatomical, histological, cytological and functional results

Cancer of the Urinary Bladder Neovagina in a Patient with Morris’ Syndrome

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