Laparoscopic vaginoplasty using a single peritoneal flap: 10 years of experience in the creation of a neovagina in patients with Mayer-Rokitansky-Küster-Hauser syndrome

Zhao, Xi Wa; Ying, Jun; Wang, Yan Xiu; Zhang, Hui; Zhang, Jun; Kang, Shan

doi:10.1016/j.fertnstert.2015.04.014

Cited by 25 publications

(14 citation statements)

References 23 publications

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“…1 Zhao et al also reported a laparoscopic vaginoplasty technique using a single peritoneal flap to obtain a longer neovagina. 4 In the present report, authors demonstrated a new surgical procedure that uses the rudimentary uterus to obtain a longer neovagina. Authors kept peritoneal mobilization to leave the thickened tissue connecting both rudimentary uteruses between the vesicouterine pouch and Douglas' pouch.…”

Section: Discussionmentioning

confidence: 80%

“…Zhao et al reported that cutting bilateral round ligaments may not have maintained the position of the pelvic cavity and prevented prolapse. 4 Authors considered that the thickened tissue connecting both rudimentary uteruses between the vesicouterine pouch and Douglas' pouch will reinforce the pelvic floor as the ceiling of the neovagina. The present procedure thus may prevent prolapse of pelvic organs in the future.…”

Section: Discussionmentioning

confidence: 99%

“…This peritoneal mobilization and the associated "pull-down" technique are complicated and difficult to perform. 4 However, mobilization of peritoneum is needed to obtain a longer neovagina. This report demonstrated a new modified laparoscopic Davydov's method that uses rudimentary uterus for MRKH syndrome due to obtain a longer neovagina.…”

Section: Introductionmentioning

confidence: 99%

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New modified laparoscopic Davydov’s method using the rudimentary uterus

Takase

Hamuro

Ashimura

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Among surgical procedures of Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome, the laparoscopic Davydov's technique seems to offer the most feasible and effective approach for creating a neovagina. Several reports have pointed at the necessity for mobilization of the peritoneum to obtain a longer neovagina and have reported a modified laparoscopic Davydov’s method. A new method was performed for a 24- and an 18-year-old patient. The most significant method in present procedure was to leave the thickened tissue that connects both rudimentary uteruses. The advantages of present procedure are physiological, creating a longer neovagina. Furthermore, this approach may help prevent prolapse of pelvic organs by leaving the thickened tissue as a ceiling.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

New modified laparoscopic Davydov’s method using the rudimentary uterus

Takase

Hamuro

Ashimura

et al. 2018

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

show abstract

“…Therefore, the graft largely determines the effect of surgery. Various substances have been used to line the newly created canal, such as a skin graft , peritoneum , buccal mucosa and bowel . However, using autologous tissue introduces unnecessary damage and complications to patients and is not the optimal choice for grafts.…”

Section: Introductionmentioning

confidence: 99%

Bone Marrow Mesenchymal Stem Cells Accelerate the Morphological and Functional Recovery of Neovaginas

et al. 2018

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Vaginal reconstruction is the main solution to the problem of sexuality and gender roles for patients with no vagina. A tissue‐engineered vagina may be the best choice. However, many defects have been found in neovaginas reconstructed with a graft only. In this study, we investigated whether a stem cell‐seeded graft would accelerate the morphological and functional recovery of neovaginas. CM‐DiI‐labeled bone marrow mesenchymal stem cell (MSC)‐seeded small intestinal submucosa (SIS) (SIS+MSCs group) was used for vaginal reconstruction in a rat model; unseeded SIS (SIS group) was used as a control. The neovaginas of each group were harvested at 4 and 12 weeks after surgery. Morphological analyses were performed using hematoxylin and eosin (H&E) staining and immunohistochemical staining for α‐smooth muscle actin (SMA), protein gene product 9.5(PGP9.5), and CD34. Functional recovery was evaluated using an organ bath study. The role of MSCs in the neovagina was analyzed by immunofluorescence and molecular biology methods. At the 4th week, a regenerated epithelium covered the whole neovagina in both groups. A small amount of smooth muscle regeneration was found in the neovagina. Up to the 12th week, nerve fibers appeared. There were more smooth muscle and nerve fibers, along with better contractility, in the neovagina of the SIS+MSCs group. Further study showed that the MSCs differentiated into smooth muscles at the 4th week. A higher microvessel density (MVD) and more vascular endothelial growth factor (VEGF) were found in the neovagina of the SIS+MSCs group. In short, MSCs accelerate the structural and functional recovery of the neovagina.

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“… 2 Recently, a series of laparoscopic vaginoplasty techniques using a single peritoneal flap in MRKH syndrome patients has been reported. 3 The advantages of using the peritoneum for vaginal reconstruction include its abundant availability, proximity to the vagina, mucosal-type surface, and self-lubrication. 4 …”

mentioning

confidence: 99%