Magnetic resonance imaging of vaginal support structure before and after Vecchietti procedure in women with Mayer–Rokitansky–Küster–Hauser syndrome

Huebner, Markus; DeLancey, John O.L.; Reisenauer, Christl; Brucker, Sara; Preibsch, Heike; Fleischer, Sabrina; Schoeller, Dorit; Stefanescu, Diana; Rall, Katharina

doi:10.1111/aogs.13350

Cited by 10 publications

(6 citation statements)

References 30 publications

(32 reference statements)

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“…Scar tissue at the apex as a result of the peritoneal tunneling during the Vecchietti procedure might enforce apical support of both cardinal and uterosacral ligaments. Missing scar tissue can explain why prolapse has been described quite often after self-dilatation [ 13 ].…”

Section: Resultsmentioning

confidence: 99%

Urogynecological and Sexual Functions after Vecchietti Reconstructive Surgery

Adamiak‐Godlewska

Skorupska

Rechberger

et al. 2019

BioMed Research International

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Hypothesis/Aims of Study. Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome is the second most common cause of primary amenorrhea. The ESHRE/ESGE categorizes this disorder within the class 5 uterine malformation of the female genital tract anomalies. It is characterized by congenital absence of the uterus, cervix, and upper part of the vagina in otherwise phenotypically normal 46XX females. These patients have normal ovaries, biphasic ovarian cycle, and female psychosexual identification. Laparoscopic Vecchietti’s operation—surgical method in which the vagina increases in size by gradually applying traction to the vaginal vault—is one of the methods used to treat MRKH. The aim of this study was to establish the urogynecological and sexual functions after Vecchietti’s operation. Study Design, Materials and Methods. Fifteen patients with MRKHS who underwent laparoscopic Vecchietti’s operation were included. A control group of 15 age-matched, childless, sexually active women were examined during the same period. All patients underwent the basic evaluation of anatomical outcomes. Sexual outcomes were established by the Polish validated Female Sexual Function Index (FSFI) questionnaire. Continence status was assessed by Polish validated Urinary Distress Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7). Results. Mean age of MRKH group was 22.06±5.13 yrs. Mean follow-up after surgery was 8.02±3.43 yrs. Mean age of women from control group was 22.4±4.35. Mean FSFI scores show good quality of sexual life in both groups. UDI-6 scores showed that patients after Vecchietti surgery have urogynecological problems significantly more often than healthy women do. Based on the IIQ-7, it is evident that one patient from the MRKH group (6,6%) suffers from stress urinary incontinence and the rest (20%) have rather irritative problems with the functioning of the lower urinary tract. Conclusion. Quality of sexual life after the Vecchietti’s operation in long-term follow-up does not differ from that of healthy women, but these patients suffer more frequent from urogynecological complaints. The trial is registered with NCT03809819.

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Section: Resultsmentioning

confidence: 99%

Urogynecological and Sexual Functions after Vecchietti Reconstructive Surgery

Adamiak‐Godlewska

Skorupska

Rechberger

et al. 2019

BioMed Research International

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“…Even though ovarian cell donors and in vitro fertilization can be carried out, the patient may still feel depressed. In patients with vaginal agenesis, surgery is also needed so that they can have sexual intercourse with partners [11] .…”

Section: Discussionmentioning

confidence: 99%

“…In some cases, the presence of intraluminal blood or adenomyosis on MRI suggests functioning endometrium in a rudimentary uterus. However, this does not affect fertility because fertility in patients with MRKH will also be disrupted [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Atypical form of Mayer-Rokitansky-Küster-Hauser syndrome: A case report

Dewi,

Randy,

Wienanda

et al. 2023

Radiology Case Reports

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“…Patients with vaginal agenesis also had near-normal sexual function and satisfactory sexual experiences after treatment according to the postoperative FSFI evaluations. Huebner et al ( 24 ) also suggested psychological counseling as part of the treatment plan for patients with MRKHS. Most patients with congenital absence of the vagina are mentally distressed due to the physical defect ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

Retrospective comparative cohort study of neovagina creation by modified Vecchietti-laparoendoscopic single-site surgery for Mayer-Rokitansky-Küster-Hauser syndrome

Zhang¹,

Zhang²,

Wang³

et al. 2022

Ann Transl Med

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Background: Although traditional multi-incision laparoscopic surgery is minimally invasive, it can still leave surgical scars on the lower abdomen. This study reports a modified Vecchietti-laparoendoscopic singlesite (MVLESS) procedure using self-made instruments to create a neovagina for Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) and to determine the efficacy and safety.Methods: We conducted a retrospective comparative cohort study analysis of the clinical data from MRKHS patients treated in the Department of Difficult Gynecological Disease at Xi'an People's Hospital between January 2010 and December 2020.Women who were diagnosed with MRKHS and underwent a MVLESS procedure using self-made instruments to create a new vagina were selected as the study group (n=14). Patients who underwent a traditional multi-incision Vecchietti (TMV) procedure were selected as the control group (n=22). All participants in both groups were required to complete a Female Sexual Function Index (FSFI) and Female Genital Self-Image Scale (FGSIS) questionnaire.Results: All patients in the study group were diagnosed with type I MRKHS and 3 (21.43%) were sexually active. Twenty-one patients in the control group were diagnosed with type I (95.45%) MRKHS, 1 (4.55%) had type II MRKHS (absent left kidney), and 6 (27.27%) were sexually active. The neovaginas in both groups were wide with good elasticity, softness, smoothness, and lubrication. There were no significant differences in operative time (37±6 vs. 39±4 minutes, P=0.98), intraoperative bleeding (28.32±9.82 vs. 29.45±3.84 mL, P=0.86), postoperative anal exsufflation time (18±4 vs. 20±4 hours, P=0.82), and postoperative hospital stay (7±2 vs. 8±2 days, P=0.84) between the MVLESS and TMV groups. The FSFI and FGSIS scores in both groups showed participants had a good quality of sexual life based on the 12-month follow-up data; however,function was significantly better in the study group than in the control group [lubrication (4.72±0.86 vs. 4.64±1.01, P=0.023), visual analog scale (VAS; 4.26±0.52 vs. 4.45±0.39, P=0.041), total FSFI scores (30.21±4.32 vs. 28.42±2.21, P=0.048), and FGSIS score (23.21±1.98 vs. 22.14±2.04, P=0.012)]. Conclusions:The MVLESS procedure is a simple, safe, and minimally invasive procedure that provides an anatomical and functional neovagina for MRKHS patients. It is an alternative method for creating a neovagina to achieve satisfactory anatomic and sexual function. However, it is still a difficult problem to solve fertility problems for patients with congenital absence of vagina.

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Magnetic resonance imaging of vaginal support structure before and after Vecchietti procedure in women with Mayer–Rokitansky–Küster–Hauser syndrome

Abstract: The preoperative presence of pelvic support structures into which the vagina is lengthened by the surgery likely explains the uncommon occurrence of vaginal prolapse in women who had the Vecchietti procedure.

Cited by 10 publications

References 30 publications

Urogynecological and Sexual Functions after Vecchietti Reconstructive Surgery

Urogynecological and Sexual Functions after Vecchietti Reconstructive Surgery

Atypical form of Mayer-Rokitansky-Küster-Hauser syndrome: A case report

Retrospective comparative cohort study of neovagina creation by modified Vecchietti-laparoendoscopic single-site surgery for Mayer-Rokitansky-Küster-Hauser syndrome

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