Top

International Urogynecology Journal

Published in:

01-08-2015 | Original Article

Comparison of two laparoscopic peritoneal vaginoplasty techniques in patients with Mayer–Rokitansky–Küster–Hauser syndrome

Authors: Xiwa Zhao, Ruixue Wang, Yanxiu Wang, Li Li, Haibo Zhang, Shan Kang

Published in: International Urogynecology Journal | Issue 8/2015

Abstract

Introduction and hypothesis

The aim of this study was to compare the technical feasibility and long-term anatomical and functional outcomes of a novel laparoscopic vaginoplasty using single peritoneal flap (SPF) and Davydov’s laparoscopic technique in patients with Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome.

Methods

From September 2004 to September 2013, a comparative study was conducted of 98 patients with MRKH syndrome who underwent either laparoscopic vaginoplasty using SPF (SPF group, 62 cases) or Davydov’s laparoscopic technique (Davydov group, 36 cases) in a university-based tertiary care hospital. Intraoperative and postoperative parameters and anatomical examination findings of the two groups were compared. Functional results were assessed using the Female Sexual Function Index (FSFI).

Results

All surgical procedures were performed successfully, with no intraoperative complications in either group. Patients in the SPF group had a significantly shorter operative time and less intraoperative blood loss than patients in the Davydov group. The postoperative course was identical for all patients in the two groups. The mean length and width of the neovagina in the two groups at hospital discharge, the 6-month follow-up, and the 12-month follow-up did not differ significantly. There were no significant differences between the groups with regard to the postoperative FSFI scores at 12 months after surgery.

Conclusions

Although the long-term anatomical and functional outcomes of the two laparoscopic peritoneal vaginoplasty techniques are similar, laparoscopic vaginoplasty using SPF, which has many advantages and is easily performed by the gynecologist, is a more feasible and effective approach to creating a neovagina in patients with MRKH syndrome.

Hauser GA, Schreiner WE (1961) Mayer-Rokitansky-Kuester syndrome. Rudimentary solid bipartite uterus with solid vagina. Schweiz Med Wochenschr 91:381–384PubMed

Rock JA, Azziz R (1987) Genital anomalies in childhood. Clin Obstet Gynecol 30(3):682–696PubMedCrossRef

Golan A, Langer R, Bukovsky I, Caspi E (1989) Congenital anomalies of the mullerian system. Fertil Steril 51(5):747–755PubMed

Edmonds DK (2000) Congenital malformations of the genital tract. Obstet Gynecol Clin N Am 27(1):49–62CrossRef

Soong YK, Chang FH, Lai YM, Lee CL, Chou HH (1996) Results of modified laparoscopically assisted neovaginoplasty in 18 patients with congenital absence of vagina. Hum Reprod 11(1):200–203PubMedCrossRef

Fedele L, Frontino G, Restelli E, Ciappina N, Motta F, Bianchi S (2010) Creation of a neovagina by Davydov’s laparoscopic modified technique in patients with Rokitansky syndrome. Am J Obstet Gynecol 202(1):33.e1–33.e6. doi:10.1016/j.ajog.2009.08.035 CrossRef

Carrard C, Chevret-Measson M, Lunel A, Raudrant D (2012) Sexuality after sigmoid vaginoplasty in patients with Mayer-Rokitansky-Küster-Hauser syndrome. Fertil Steril 97(3):691–696. doi:10.1016/j.fertnstert.2011.12.015 PubMedCrossRef

Fedele L, Bianchi S, Frontino G, Fontana E, Restelli E, Bruni V (2008) The laparoscopic Vecchietti’s modified technique in Rokitansky syndrome: anatomic, functional, and sexual long-term results. Am J Obstet Gynecol 198(4):377.e1–377.e6. doi:10.1016/j.ajog.2007.10.807 CrossRef

Cao L, Wang Y, Li Y, Xu H (2013) Prospective randomized comparison of laparoscopic peritoneal vaginoplasty with laparoscopic sigmoid vaginoplasty for treating congenital vaginal agenesis. Int Urogynecol J 24(7):1173–1179. doi:10.1007/s00192-012-1991-9 PubMedCrossRef

10.

Bianchi S, Frontino G, Ciappina N, Restelli E, Fedele L (2011) Creation of a neovagina in Rokitansky syndrome: comparison between two laparoscopic techniques. Fertil Steril 95(3):1098–1100.e3. doi:10.1016/j.fertnstert.2010.11.032 PubMedCrossRef

11.

Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, Ferguson D, D’Agostino R Jr (2000) The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26(2):191–208PubMedCrossRef

12.

Herman CJ, Willesman WN, Mastboom JL, Vooijs GP (1982) Artificial vaginas: possible sources of epithelialization. Hum Pathol 13(12):1100–1105PubMedCrossRef

13.

Laufer MR (2002) Congenital absence of the vagina: in search of the perfect solution. When, and by what technique, should a vagina be created? Curr Opin Obstet Gynecol 14(5):441–444PubMedCrossRef

14.

Hensle TW, Chang DT (1999) Vaginal reconstruction. Urol Clin N Am 26(1):39–47CrossRef

15.

Frank R (1938) The formation of an artificial vagina without operation. Am J Obstet Gynecol 35:1053

16.

Walker JL, Piedmonte MR, Spirtos NM, Eisenkop SM, Schlaerth JB, Mannel RS, Spiegel G, Barakat R, Pearl ML, Sharma SK (2009) Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: gynecologic oncology group study LAP2. J Clin Oncol 27(32):5331–5336. doi:10.1200/JCO.2009.22.3248 PubMedCentralPubMedCrossRef

17.

Karateke A, Haliloglu B, Parlak O, Cam C, Coksuer H (2010) Intestinal vaginoplasty: seven years’ experience of a tertiary center. Fertil Steril 94(6):2312–2315. doi:10.1016/j.fertnstert.2010.01.004 PubMedCrossRef

18.

Zhou JH, Sun J, Yang CB, Xie ZW, Shao WQ, Jin HM (2010) Long-term outcomes of transvestibular vaginoplasty with pelvic peritoneum in 182 patients with Rokitansky’s syndrome. Fertil Steril 94(6):2281–2285. doi:10.1016/j.fertnstert.2010.02.010 PubMedCrossRef

19.

Templeman CL, Hertweck SP, Levine RL, Reich H (2000) Use of laparoscopically mobilized peritoneum in the creation of a neovagina. Fertil Steril 74(3):589–592PubMedCrossRef

20.

Rothman D (1972) The use of peritoneum in the construction of a vagina. Obstet Gynecol 40(6):835–838PubMed

21.

Giannesi A, Marchiole P, Benchaib M, Chevret-Measson M, Mathevet P, Dargent D (2005) Sexuality after laparoscopic Davydov in patients affected by congenital complete vaginal agenesis associated with uterine agenesis or hypoplasia. Hum Reprod 20(10):2954–2957PubMedCrossRef

22.

Liu X, Liu M, Hua K, Li B, Guo SW (2009) Sexuality after Laparoscopic Peritoneal Vaginoplasty in Women with Mayer-Rokitansky-Kuster-Hauser Syndrome. J Minim Invasive Gynecol 16(6):720–729. doi:10.1016/j.jmig.2009.07.018 PubMedCrossRef

23.

Dargent D, Marchiole P, Giannesi A, Benchaib M, Chevret-Measson M, Mathevet P (2004) Laparoscopic Davydov or laparoscopic transposition of the peritoneal colpopoiesis described by Davydov for the treatment of congenital vaginal agenesis: the technique and its evolution. Gynecol Obstet Fertil 32(12):1023–1030PubMedCrossRef

Title: Comparison of two laparoscopic peritoneal vaginoplasty techniques in patients with Mayer–Rokitansky–Küster–Hauser syndrome
Authors: Xiwa Zhao
Ruixue Wang
Yanxiu Wang
Li Li
Haibo Zhang
Shan Kang
Publication date: 01-08-2015
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 8/2015
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-015-2675-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Comparison of two laparoscopic peritoneal vaginoplasty techniques in patients with Mayer–Rokitansky–Küster–Hauser syndrome

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2015

The Manchester–Fothergill and the Elevate Posterior® technique for the correction of a cervical elongation and large enterocele in a patient with bladder exstrophy and multiple surgeries

Pre-departure preparation for international clinical work: a handbook

Urogynecology digest

Circumferential urethral fistulae in Sub-Saharan Africa, current outcomes and future prospects

Multidisciplinary team meetings in urogynaecology

High uterosacral vault suspension vs Sacrocolpopexy for treating apical defects: a randomized controlled trial with twelve months follow-up