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Archives of Gynecology and Obstetrics

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19-07-2023 | Review

Neovagina creation methods in Müllerian anomalies and risk of malignancy: insights from a systematic review

Authors: Francesco Fedele, Alessandro Bulfoni, Fabio Parazzini, Andrea Busnelli

Published in: Archives of Gynecology and Obstetrics | Issue 3/2024

Abstract

Purpose

This systematic review aims to provide a data synthesis about the risk of neovaginal cancer in women with Müllerian anomalies and to investigate the association between the adopted reconstructive technique and the cancer histotype.

Methods

PubMed, MEDLINE, Embase, Scopus, ClinicalTrials.gov and Web of Science databases were searched from inception to March 1st, 2023. Studies were included if: (1) only women affected by Müllerian malformations were included, (2) the congenital defect and the vaginoplasty technique were clearly reported, (3) the type of malignancy was specified.

Results

Literature search yielded 18 cases of squamous cell carcinoma and two cases of vaginal intraepithelial neoplasia 3 (VAIN 3). Of these, 3 had been operated on according to the Wharton technique, 8 according to the McIndoe technique, 3 with a split-skin graft vaginoplasty, 2 according to the Davydov technique, 2 with a simple cleavage technique, 1 according to the Vecchietti technique and 1 with a bladder flap vaginoplasty. A total of 17 cases of adenocarcinoma and 1 case of high-grade polypoid dysplasia were also described. Of these, 15 had undergone intestinal vaginoplasty, 1 had been operated on according to the McIndoe technique and 1 had undergone non-surgical vaginoplasty. Finally, 1 case of verrucous carcinoma in a woman who had undergone a split-skin graft vaginoplasty, was reported.

Conclusion

Although rare, neovaginal carcinoma is a definite risk after vaginal reconstruction, regardless of the adopted technique. Gynaecologic visits including the speculum examination, the HPV DNA and/or the Pap smear tests should be scheduled on an annual basis.

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Title: Neovagina creation methods in Müllerian anomalies and risk of malignancy: insights from a systematic review
Authors: Francesco Fedele
Alessandro Bulfoni
Fabio Parazzini
Andrea Busnelli
Publication date: 19-07-2023
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 3/2024
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-023-07086-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Neovagina creation methods in Müllerian anomalies and risk of malignancy: insights from a systematic review

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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