McIndoe procedure for vaginal agenesis: Long-term outcome and effect on quality of life

Klingele, Christopher J.; Gebhart, John B.; Croak, Andrew J.; DiMarco, Connie S.; Lesnick, Timothy G.; Lee, Raymond A.

doi:10.1016/s0002-9378(03)00938-4

Cited by 88 publications

(65 citation statements)

References 10 publications

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“…11 Surgical methods of neovaginal creation make oocyte retrieval more difficult than graded perineal dilatation. 12 A high lateral placement of ovaries has been described in patients with Müllerian agenesis who undergo oocyte retrieval for gestational carrier treatment.…”

Section: Discussionmentioning

confidence: 99%

Vaginal Reconstruction in Müllerian Agenesis with User- Friendly Indigenous Prosthetic Vaginal Dilators

Lnu¹,

Syamala²,

Lnu³

et al. 2014

Journal of SAFOMS

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Objective: Vaginal reconstruction in Müllerian agenesis through nonsurgical method, using serial vaginal dilators which were worn by the patients with the help of a T-shaped peri neal bandage. Materials and methods:Seven patients with Müllerian agenesis had attended the outpatient clinic between 2008 and 2013. The age of women ranged from 18 to 30 years. This clinical report describes the use of prosthesis, fabricated by a maxillofacial prosthodontist that enabled the patients to have custom made personalized vaginal dilators of increasing dimen sions which they could wear with comfort with a tight perineal T-bandage.Results: Seven women with Müllerian agenesis had consented for nonsurgical mode of vaginal reconstruction. Vagina was serially dilated with tailor made prosthesis worn using tight perineal T-bandage for a period of 3 to 4 months. Post dilatation average vaginal length was 11 to 13 cm which allowed intro duction of Sims speculum with ease. Conclusion:Nonsurgical vaginal dilatation using prosthetic vaginal dilators kept in place with tight perineal T-bandage is a well-accepted custom made and a successful technique in the creation of neovagina.

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Section: Discussionmentioning

confidence: 99%

Vaginal Reconstruction in Müllerian Agenesis with User- Friendly Indigenous Prosthetic Vaginal Dilators

Lnu¹,

Syamala²,

Lnu³

et al. 2014

Journal of SAFOMS

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“…The greft becomes epithelialized during the following period and covers the new forming vagina. Low morbidity and having no need to abdominal approach can be mentioned as advantages but also have disadvantages as worse cosmetic results at greft space, need of dilator usage after operation, stenosis in new vagina, need of lubricant use in intercourse (6,13) .…”

Section: Discussionmentioning

confidence: 99%

Mayer-Rokitansky-Küster-Hauser Syndome and Laparoscopic Assisted Creation of Neovagina (Modified Vecchietti)

Şendağ¹,

Akdemir²,

Akman³

et al. 2013

J Turk Soc Obstet Gynecol

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“…Mean age at the time of presentation was 21.9 years (range: 18-24 years). Before surgery, all patients were informed about other available surgical and non-surgical procedures such as laparotomic sigmoid vaginoplasty, lining of the neovaginal space with a split-thickness skin graft according to McIndoe [11], creation of a neovagina using the patient's peritoneum as a lining (Davydov procedure) or conservative creation of a neovagina according to the method described by Frank [13]. In addition, all women underwent sonographic examination of the pelvis and the urinary system, and no further anomalies of the urinary tract or skeletal system were observed.…”

Section: Patient Datamentioning

confidence: 99%

“…Non-surgical approaches include dilatation of the vaginal groove with a hand-held dilator in a squatting position first described by Frank [13,20] or by passive dilatation using the patient's own weight according to the method of Ingram [8]. In addition, various surgical methods have been described such as the creation of a split-thickness skin graft which covers a stent inserted into the space between bladder and rectum (McIndoe and Bannister) [11], the use of the patient's own peritoneum for vaginal reconstruction (Davydov technique) [5] or creation of a neovagina with a sigmoid graft [4]. Although there is no standardized method, the majority of surgically treated cases (up to 300) have been described by Vecchietti [18,19] who proposed a combination of the surgical and conservative approaches by performing a laparotomy, dissection of the vesico-rectal septum followed by fixation of a vaginal "dilatation olive" with two sutures passing from the abdominal wall through the pseudohymenal septum.…”

Section: Introductionmentioning

confidence: 99%

Long-term outcome after laparoscopic creation of a neovagina in patients with Mayer-Rokitansky-Küster-Hauser syndrome by a modified Vecchietti procedure

Keckstein¹,

Kandolf²,

Rauter³

et al. 2007

Gynecol Surg

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Several conservative and surgical methods have been proposed for patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. The technique described by Vecchietti is a combination of both dilatation and surgery. We describe a minimally invasive modification of this approach including dissection of the vesico-rectal septum and present long-term patient outcome. Eight patients who underwent surgery at our department between 1996 and 2005 for MRKH syndrome were included in the present analysis. Post-operative follow-up and a semi-structured telephone interview were performed to obtain information on neovaginal functionality, immediate and long-term postoperative outcome, sexual function and physiological and psychological well-being evaluated on a 10-point scale and by the Sintonen 15D questionnaire. After a median postoperative (median operation time: 88 min, range: 63-116 min) follow-up period of 40.3 months (range: 18-84 months) without major complications and a median post-operative stay of 13.8 days (range: 6-15 days), a functional neovagina was created in seven of eight patients. Median vaginal length at the time of discharge from the hospital ranged between 7 and 10 cm (median: 9.6 cm) and reached 11.5 cm (range: 5-15 cm) at the time of evaluation. Except for one patient who neither had regular sexual intercourse nor used the vaginal dilator, sexual intercourse was quoted as satisfactory in six cases (one patient still used the dilator only). Patients reported an improvement of quality of life (mean: 8.1, range: 5-10) and self-confidence (8.1, range: 5-10) and general well-being evaluated by the Sintonen 15D questionnaire (average score of 1.8, SD= 0.06). The laparoscopic-assisted Vecchietti procedure with dissection of the vesico-rectal septum is a safe and effective method for creation of a neovagina in MRKH patients.

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McIndoe procedure for vaginal agenesis: Long-term outcome and effect on quality of life

Cited by 88 publications

References 10 publications

Vaginal Reconstruction in Müllerian Agenesis with User- Friendly Indigenous Prosthetic Vaginal Dilators

Vaginal Reconstruction in Müllerian Agenesis with User- Friendly Indigenous Prosthetic Vaginal Dilators

Mayer-Rokitansky-Küster-Hauser Syndome and Laparoscopic Assisted Creation of Neovagina (Modified Vecchietti)

Long-term outcome after laparoscopic creation of a neovagina in patients with Mayer-Rokitansky-Küster-Hauser syndrome by a modified Vecchietti procedure

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