The use of isolated sigmoid colon segment for vaginal replacement in young adults

Moudouni, S.; Koutani, Abdellatif; Attya, A Ibn; Hachimi, M; Lakrissa, A

doi:10.1007/s11255-004-0861-x

Cited by 17 publications

(32 citation statements)

References 17 publications

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“…Mucous discharge was experienced initially by all patients, which decreased thereafter with the use of frequent douching to evacuate the mucous, which was comparable to other series [3,22]. Mucous is a natural lubricant and decreases by time.…”

Section: Discussionsupporting

confidence: 80%

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Vaginal reconstruction with sigmoid colon in vaginal agenesis

et al. 2007

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This study was conducted to evaluate the anatomical and functional results of sigmoid colon vaginoplasty. From June 2000 to June 2005, 26 patients with congenital vaginal agenesis were evaluated and treated with sigmoid colon reconstruction at Ain Shams University Maternity Hospital as a primary procedure in 17 patients and a secondary procedure in 9 patients after previous failed Abbe-McIndoe vaginoplasty elsewhere. The anatomical results were good in 22 patients, while 3 patients suffered from introital stenosis. Two of them were treated successfully by dilatation while one required Z-plasty. Eight patients were lost to follow-up and only ten patients are currently sexually active as the rest were divorced or remained unmarried. Of the sexually active patients, 8 (80%) had satisfactory intercourse whereas 2 (20%) complained of dyspareunia. Sigmoid colon vaginoplasty has satisfactory long-term anatomical and functional results and should be considered as primary option for the treatment of vaginal agenesis.

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Section: Discussionsupporting

confidence: 80%

“…Average operative time was 184 min (160-210). Average hospital stay was 11 days (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22).…”

Section: Resultsmentioning

confidence: 99%

Vaginal reconstruction with sigmoid colon in vaginal agenesis

et al. 2007

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“…The liability for anastomotic stricture can be decreased by selection of a bowel segment of adequate blood supply and length that can be mobilized and pulled easily to the perineum without tension, creation of a large enough space between bladder and rectum and generous anastomosis at the hymenal region. The need for regular vaginal dilatation after sigmoid vaginoplasty was advised by some authors (21) while others did not recommend it (22). When we analyzed our data, we found that all cases with vaginal stenosis were sexually inactive and reluctant to perform self vaginal dilatation .Therefore, we propose that regular postoperative dilatation of the anastomotic site till full sexual activity (once/week at least) is preferred to decrease the incidence of this complication.…”

Section: Discussionmentioning

confidence: 85%

“…Moreover, a cosmetic neovagina of adequate size was also obtained among the 3 recurrent cases with previous failed vaginoplasty using skin graft so we suggest the use of sigmoid vaginoplasty in secondary cases although the limited number of this patient`s category in our series. Other studies also reported good cosmetic and functional results of sigmoid vaginoplasty (22,27) whereas other authors reported periumbilical pain during intercourse in 5.6% of patients and considered this pain a disadvantage of this procedure (24). With assessment of the functional outcome among the 9 sexually active patients in our series, none of them complained of this pain whereas good results were obtained as all patients experienced intercourses that were satisfactory for them and for their partners.…”

Section: Discussionmentioning

confidence: 95%

Surgical and functional outcomes of sigmoid vaginoplasty among patients with variants of disorders of sex development

2012

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PURPOSE:To assess the use of sigmoid colon in vaginal reconstruction of some patients with disorders of sex development. MATERIALS AND METHODS: The study included 31 patients with disorders of sex development of various causes. All were reared as females. Female gender was decided for all cases after complete medical assessment. All patients underwent sigmoid vaginoplasty. Assessment of surgical and functional outcomes was carried out in a follow up period of up to 6 years. RESULTS: The preoperative diagnoses included mullerian aplasia (16 cases), androgen insensitivity syndrome (12 cases) and previous failed vaginoplasty (3 cases). Associated surgical procedures were gonadectomy in 5 cases and gonadectomy combined with clitoroplasty and vulvoplasty in 7 cases. No intra-operative or early postoperative complications occurred. A cosmetic neovagina with adequate size was achieved in all cases. Long term follow up showed introital stenosis in 4 cases (12.9 %). Two of them responded to vaginal dilatation. The third one needed y-v plasty while the fourth one presented by acute abdomen secondary to ruptured vagina and was submitted to urgent laparotomy. Mucosal prolapse occurred in 1 case (3.2%). Reoperation rate was 9.6%. Sexual satisfaction was achieved among 9 sexually active cases. The subjective satisfaction score of the surgical outcome was 8.03. CONCLUSIONS: For patients with disorders of sex development of various etiologies, sigmoid vaginoplasty is the preferred technique for vaginal replacement. It is a safe technique that provides the patient with a cosmetic neovagina of adequate caliber and a satisfactory functional outcome

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“…However, these procedures involve laparotomy and bowel anastomosis, which are procedures associated with increased morbidity. Furthermore, they are not free of complications and instances of restenosis requiring revision are well described [8,9] . Therefore the decision for the neovaginopasty technique still depends on the surgeon's expertise and preferences.…”

Section: Discussionmentioning

confidence: 99%

Single-Stage Correction of Urinary Incontinence and Vaginoplasty in a Case of Urethral Coitus with Vaginal Agenesis

Khattar¹,

Dorairajan²,

Kumar³

et al. 2008

Urol Int

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Urethral coitus is a very rare entity which usually presents as urethral incontinence during intercourse and is most commonly seen with intact vagina. Only about 24 cases have been reported in the literature. A presentation in vaginal agenesis is exceedingly rare and poses the surgical challenge of restoring continence without interfering with sex life. Here we report a case of urethral intercourse with vaginal agenesis presenting with incontinence that we treated with McIndoe’s vaginoplasty and urethral plication in a single stage, with satisfactory result. To the best of our knowledge, this method of reconstruction has not yet been reported for this condition.

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The use of isolated sigmoid colon segment for vaginal replacement in young adults

Abstract: Experience with this group of patients leads us to believe that isolated sigmoid segments provides a cosmetic, self-lubricating neovagina with low rates of failure and revision, and without the need for routine dilation.

Cited by 17 publications

References 17 publications

Vaginal reconstruction with sigmoid colon in vaginal agenesis

Vaginal reconstruction with sigmoid colon in vaginal agenesis

Surgical and functional outcomes of sigmoid vaginoplasty among patients with variants of disorders of sex development

Single-Stage Correction of Urinary Incontinence and Vaginoplasty in a Case of Urethral Coitus with Vaginal Agenesis

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