Vaginal reconstruction with sigmoid colon in vaginal agenesis

Elsayed, H M; El-Lamie, Ismail K.; Ibrahim, Ahmed M. S.; El-Lamie, Khalil I.

doi:10.1007/s00192-006-0287-3

Cited by 24 publications

(26 citation statements)

References 23 publications

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“…One case without sexual life experience did not report discomforts of irritation or difficult usage of mold vagina. The sexual life satisfaction rate in this study is similar to the reported level of more than 80% [22,23], which further confirmed the orthopedic effect of sigmoid vaginoplasty. It has been reported that the neovagina was relatively insensitive and may have excess mucus production requiring the patient to wear pads permanently [3].…”

Section: Discussionsupporting

confidence: 93%

Laparoscopic sigmoid vaginoplasty in women with Mayer-Rokitansky-Kuster-Hauser syndrome

Shen¹,

Wang²,

Xiong³

et al. 2009

Front. Med. China

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The feasibility and clinical therapeutic effects of laparoscopic sigmoid vaginoplasty in women with Mayer-Rokitansky-Kuster-Hauser syndrome (MRKHs) were explored. The records of 11 MRKHs patients who underwent laparoscopic sigmoid vaginoplasty from 2003 to 2005 were reviewed, and long-term results were evaluated by follow-up. The mean operating time was 234 min (range, 130-300 min), the mean hospital stay was 9.4 days (range, 7-15 days), and the mean hemoglobin drop was 1.91 g/dL (range, 1.6-3.2 g/dL). A functional neovagina was created measuring 11 to 14 cm in length and two fingers in breadth in all patients. No introitus stenosis was observed. No intra-operative or postoperative bowel complication occurred. At the 3rd postoperative month, the first intercourse began. One patient was lost to follow-up. One had no intercourse and was required to wear vaginal mold occasionally. None of the other nine women (100%) complained of local irritation or dyspareunia. They were satisfied with their sexual life. The cosmetic results were excellent. The laparoscopic sigmoid vaginoplasty realizes to make a functional neovagina. The main advantage is its minimal invasiveness. It is an ideal procedure for MRKHs patients.

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Section: Discussionsupporting

confidence: 93%

Laparoscopic sigmoid vaginoplasty in women with Mayer-Rokitansky-Kuster-Hauser syndrome

Shen¹,

Wang²,

Xiong³

et al. 2009

Front. Med. China

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“…[14][15][16][17] and that of laparoscopy group was 8.5 days (IQR, [7][8][9][10][11]. No patients developed intestinal obstruction, bowel adhesions, intestinal perforation, contracture of the mucocutaneous junction, ulcerative colitis, or fistula.…”

Section: Resultsmentioning

confidence: 99%

“…Vaginoplasty using rectosigmoid colon allows a reduced rate of vaginal contracture and shortening. It also has excellent advantages in the sufficient gain in vaginal length, natural mucous secretion with a normal lubricating effect, which is credited as the most natural way of mimicking the normal vagina that can be obtained by the use of extravaginal tissue [2][3][4][8][9][10][11]. However, it also accompanies incision of the intraperitoneal cavity after perineal dissection and incision into the abdominal wall to procure the segment of rectosigmoid colon, which may be associated with postoperative adhesive complications of the bowel.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic rectosigmoid flap vaginoplasty

Kim¹,

Jeong²,

Kwon³

et al. 2011

Journal of Plastic Surgery and Hand Surgery

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Various methods have been developed for vaginoplasty, of which the rectosigmoid flap has its own advantages including sufficient increase in the vaginal length and lower incidence of complications such as contracture or strain after vaginoplasty. Laparoscopic operation can greatly minimise the abdominal scar associated with laparotomy and allow cosmetically superior outcomes. Its minimally invasive procedure can also achieve rapid recovery and shorten the duration of hospital stay. Twelve patients (age range 18-40 years) had vaginoplasty using the rectosigmoid colon. We evaluated the ecological changes of the neovagina from the change of pH in the neovagina, culture of the normal flora, and vaginal wall biopsy taken 6 to 12 months postoperatively. Details of sexual activity were also examined. No patient from interviews developed vaginal narrowing as a result of the contracture that caused painful intercourse, or had smelly discharge or spontaneous bleeding from the vagina. Laparoscopic procedures may need only five-openings of 1-1.5 cm in diameter. Mean operating time was 130 minutes (IQR, 113-140) and duration of hospital stay 8.5 days (IQR, 7-11). Twelve months postoperatively the intravaginal pH was about 6. In one case, the histological test showed that the original columnar cell of the intestinal mucosa had been transformed to stratified squamous cell tissue. The key to the vaginoplasty is that it should give functional satisfaction and a minimal rate of complications. The laparoscopic rectosigmoid flap technique of vaginoplasty allowed less morbidity and excellent aesthetic and functional postoperative outcomes.

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“…The American College of Obstetrics and Gynaecology suggests progressive dilatation as the first-line treatment for vaginal agenesis, and surgery is offered to those patients who failed the conservative techniques [7]. Surgical procedure options include use of bowel segments, peritoneum (Davydov's technique), Vecchietti's operation and Abbé-McIndoe vaginoplasty [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Oestrogen receptor alpha expression in neovaginal tissue of women following modified Abbé-McIndoe technique and in premenopausal women

Kajikawa¹,

Bella²,

Dornelas³

et al. 2015

Gynecological Endocrinology

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The aim of the study was to compare the expression of oestrogen receptor alpha (ERα) in neovaginal tissue of patients with vaginal agenesis following neovaginoplasty using regenerated, oxidised cellulose in premenopausal women. A prospective, observational case-control study was performed on eight patients with vaginal agenesis following modified Abbé-McIndoe neovaginoplasty and 10 control premenopausal women following benign gynaecologic surgery. 6F11 monoclonal antibody was used to determine ERα expression in the vaginal mucosa. Quantitative and qualitative evaluations were performed, respectively, in vaginal epithelium and stroma. The thickness of the vaginal epithelium was determined as the vertical distance between the basal layer cells and the apical surface of the superficial layer. The percentage of ERα-expressing cells was higher in the control group, except in the superficial zone of the epithelium. In the stromal tissue, ERα was detected in only one patient from the neovagina group compared with nine women in the control group. The neovagina group had a statistically thinner epithelium. Our study suggests that women with vaginal agenesis following modified Abbé-McIndoe neovaginoplasty using regenerated oxidised, cellulose experience relatively local hypo-oestrogenism in the first year after surgery, with repercussion in vaginal trophism.

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Vaginal reconstruction with sigmoid colon in vaginal agenesis

Cited by 24 publications

References 23 publications

Laparoscopic sigmoid vaginoplasty in women with Mayer-Rokitansky-Kuster-Hauser syndrome

Laparoscopic sigmoid vaginoplasty in women with Mayer-Rokitansky-Kuster-Hauser syndrome

Laparoscopic rectosigmoid flap vaginoplasty

Oestrogen receptor alpha expression in neovaginal tissue of women following modified Abbé-McIndoe technique and in premenopausal women

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