Colon replacement of vagina to restore menstrual function in 11 adolescent girls with vaginal or cervicovaginal agenesis

Abstract

This group of patients forms a separate subgroup needing a conduit not only for sexual function but also for menstruation. However, if treated by the method described herein, they should be cautioned against pregnancy if they have cervicovaginal agenesis and against vaginal delivery if they have vaginal agenesis.

Bowel vaginoplasty in children and young women: an institutional experience with 55 patients

“…These include excessive mucosal discharge, bowel obstruction, anastomotic leaks, bladder/ureteral injury, stenosis, prolapse, polyp formation, diversion colitis, ulcerative colitis and rarely malignancy [1,15]. Despite these complications, several authors have reported successful bowel vaginoplasties [1,2,4,15,16]. Clearly, the multiplicity of procedures for this complex anomaly indicates that there is no perfect solution.…”

“…Further, ours is a conservative society where the loss of the vagina and fertility makes it very unlikely for the patient to get married [19]. The utero-coloneovaginoplasty, described earlier by Kanniayan and Sen, is tailored to meet this need-ensuring a safe, wide, epithelially lined, lubricated conduit for menses and coitus, at the cost of infertility [4]. The wide anastomosis provides free drainage of the menstrual blood, thus preventing haematometra and pyometra [4,19].…”

“…The utero-coloneovaginoplasty, described earlier by Kanniayan and Sen, is tailored to meet this need-ensuring a safe, wide, epithelially lined, lubricated conduit for menses and coitus, at the cost of infertility [4]. The wide anastomosis provides free drainage of the menstrual blood, thus preventing haematometra and pyometra [4,19]. We have performed utero-coloneovaginoplasty on 30 patients (cervicovaginal atresia, n=20, MRKH, n=9, cervical atresia, n=1).…”

“…1). This technique was described earlier by authors from our institution, Kanniayan and Sen, in 2009 [4]. The reconstruction was oriented antiperistaltic (n=34) or isoperistaltic (n=16) based on the surgeon's preference and the vascular anatomy.…”

“…Congenital Mullerian defects include Mayer-Rokitansky-Küster-Hauser syndrome (MRKH), cervicovaginal atresia and isolated total or segmental vaginal atresia. The incidence of MRKH is 1 in 4,500, while it remains unknown in cervicovaginal atresia and vaginal atresias [3,4]. The acquired causes are rare and include trauma and malignancy [1].…”