Comparison of the modified laparoscopic Vecchietti and Davydov colpoplasty techniques in Mayer‐Rokitansky‐Küster‐Hauser syndrome: A long‐term follow‐up analysis

Abstract

AimsTo introduce and compare the modified laparoscopic Vecchietti and Davydov techniques for vaginoplasty in patients with Mayer‐Rokitansky‐Küster‐Hauser (MRKH) syndrome. Moreover, the long‐term treatment of vaginal agenesis was followed‐up.MethodsThis comparative retrospective cohort study enrolled a total of 53 women with MRKH syndrome. The patients underwent surgical creation of a neovagina including 32 patients who underwent the modified laparoscopic Vecchietti technique, and 21 patients who underwent the modified laparoscopic Davydov technique from January 2009 to February 2019. The perioperative parameters, complications, anatomical, and functional outcomes of the two groups were compared. Patients' sexual functions were evaluated over a long‐term follow‐up using the female sexual function index (FSFI) and the revised female sexual distress scale (FSDS‐R).ResultsThe medians (25th–75th) of the surgery duration for modified Vecchietti procedures was 50.0 (40.0–59.0) minutes, comparing to 135.0 (117.5–162.5) min for Davydov procedures (p < 0.001). The intraoperative blood loss was 20 (7.5–20.0) mL versus 50.0 (50.0–100.0) mL using the modified Vecchietti and Davydov approaches (p < 0.001), respectively. In the 39 follow‐up cases, the lengths of the neovagina of the patients for Vecchietti group versus Davydov group were 7.9 ± 1.0 cm versus 8.6 ± 1.2 cm at 6 months after the vaginoplasty and 8.3 ± 0.7 cm versus 8.5 ± 0.9 cm after 2 years. There was no statistical difference in the FSFI and FSDS‐R scores between the two groups.ConclusionsBoth the modified Davydov and Vecchietti laparoscopic procedures successfully achieved optimal anatomic and functional outcomes in treatments of vaginal agenesis. The modified Vecchietti technique is relatively simpler than the modified Davydov technique.

Long term sexual outcomes of Mayer Rokitansky Küster Hauser Syndrome patients after Uncu-modified Davydov procedure

“…In addition to achieving a suitable vaginal length, our patients also demonstrated favourable outcomes in terms of their FSFI scores (mean FSFI: 31.4 + 3.9) when compared to patients who underwent surgical procedures such as Davydov, Vecchietti, or McIndoe techniques. (Zhao et al, 2015;Dong et al, 2015;Yang et al, 2022;Zhou et al, 2022;Rall et al, 2021;Kang et al, 2020;Zhang et al, 2019;Pastor et al, 2017;Zhang et al, 2017;Ding et al, 2015;Zhao et al, 2015) (Table II).…”

Laparoscopic Neovagina Creation by Using Modified Davydov Technique

“…[5][6][7][8] Based on the FSFI results of the patients, postoperative sexual satisfaction rates were comparable with the age-matched controls except for insufficient lubrication and rare mild superficial/deep dyspareunia which was reported in one study. 9,10 Subjectivity of sexual satisfaction evaluation tests and patients' motivation to maintain their neovaginal integrity by performing regular coital activity preclude the reliability of the studies' postoperative sexual satisfaction results. In conclusion, the laparoscopic modified Davydov technique is an effective and safe surgical procedure to create a neovagina for vaginal agenesis with high postoperative sexual satisfaction scores.…”

Vaginoplasty for Gender Dysphoria and Mayer-Rokitansky-Küster-Hauser Syndrome: A Systematic Review and Meta-analysis

“…Sexual activity varied gravely as 21-100% at 1-132 post-operative months during assessment (Figure S6A/B). The definitions of sexual activity in the included articles varied as regular activity, 58,73,74,77 any 14,17,[78][79][80]41,44,60,61,66,70,72,75 in the last month, 47,62 vaginal intercourse 43,45,81,82 with a man 25 or married with sexual activity. 83 Sexual function was assessed most often with the Female Sexual Function Index (FSFI).…”

“…83 Sexual function was assessed most often with the Female Sexual Function Index (FSFI). 16,17,76,78,80,81,84,25,47,[62][63][64]70,72,73 Dyspareunia was also reported by 5-point, 60 4-point, 59 3-point 68 and 2-point 17,25,70,72,73,76,79,83,43,44,48,55,58,61,64,66 self-made questionnaires and present after all but the Wharton-Sheares-George-technique (Figure S6C/D).…”