VAGINOPLASTY BY USING AMNION GRAFT IN PATIENTS OF VAGINAL AGENESIS ASSOCIATED WITH MAYOR-ROKITANSKYKUSTER-HAUSER SYNDROME
AbstractBackground: Vaginal agenesis is congenital anomaly of the female genital tract and may occur asisolated developmental defect or as part of a complex of anomalies. The aim of this study was todetermine the effectiveness of vaginoplasty by using amnion as graft in the creation of neovagina forpatients with Mayor-Rokitansky-Kuster-Hauser Syndrome. Methods: this is a retrospective study of 28cases of vaginal agenesis associated with Mayor-Rokitansky-Kuster-Hauser Syndrome, over the periodof 20 years, in which vaginoplasty was done by modified McIndoe procedure by using amnion as graft.Results: vaginoplasty using amnion graft was successfully performed in all except one case in whichrectum got opened and procedure was abandoned after the repair of rectum. The functional results werequite satisfactory. Except one case none had any significant peri-operative complication. Post surgicalresults were acceptable to the patients sexually and aesthetically. Conclusion: Although newtechniques of vaginoplasty have evolved over the years using laparoscopic approach and by use ofdifferent materials as graft, vaginoplasty with amnion graft is still a safe and effective procedure to treatpatients of vaginal agenesis. The technique is simple and safe and provides a satisfactory and functionalvagina in majority of the patients.Keywords: vaginoplasty, amnion graft, vaginal agenesis, vaginal atresia, Mayor-RokitanskyKuster-Hauser Syndrome
Saxena AK, Herman MI. Vaginal Atresia. Webpage. Cited
June 02, 2009. Available at: http://emedicine.medscape.com/
Saraf S, Saraf P. McIndoe vaginoplasty: revisited. Internet J
Gynecol Obstetr 2007;6(2). Online Journal. Cited August 18,
Available from: http://www.ispub.com/journal/the
Gupta NP, Ansari MS. Mayer-Rokitansky-Kuster-Hauser
(MRKH) syndrome–a review. Indian J Urol 2002;18:111–6.
Kirsch AJ, Kaye JD, Carter SM, Gross SJ. Mayer-Rokitansky
syndrome. Webpage. Cited June 02, 2009. Available from:
Chohan A, Burr F, Mansoor H, Falak T. Amnion graft in
vaginoplasty–an experience at 3 teaching hospitals of Lahore.
Fotopoulou C, Sehouli J, Gehrmann N, Schoenborn I,
Lichtenegger W. Functional and anatomical results of
amnion vaginoplasty in young women with MayerRokitansky-Kuster-Hauser syndrome. Fertil Steril 2009;
(Epub ahead of print).
Rothman D. The use of peritoneum in the construction of a
vagina. Obstet Gynecol 1972;40:835–8.
Jackson ND, Rosenblatt PL. Use of interceed absorbable
adhesion barrier for vaginoplasty. Obstet Gynecol
Noguchi S, Nakatsuka M, Sugiyama Y, Chekir C, Kamada
Y, Hiramatsu Y. Use of artificial dermis and recombinant
basic fibroblast growth factor for creating a neovagina in a
patient with Mayer-Rokitansky-Kuster-Hauser syndrome.
Hum Reprod 2004;19:1629–32.
Lin WC, Chang CYY, Shen YY, Tsai HD. Use of autologous
buccal mucosa for vaginoplasty: a study of eight cases. Hum
Cai B, Zhang JR, Xi XW, Yan Q, Wan XP. Laparoscopically
assisted sigmoid colon vaginoplasty in women with MayerRokitansky-Kuster-Hauser syndrome: feasibility and short
term results. BJOG 2007;114:1486–92.
Creatsas G, Deligeoroglou E, Makrakis E, Kontoravdis A.
Papadimitriou L. Creation of a neovagina following Williams
vaginoplasty and Creatsas modification in 111 patients with
Mayer-Rokitansky-Kuster-Hauser syndrome. Fertil Steril
Kim C, Campbell B, Ferrer F. Robotic sigmoid vaginoplasty:
a novel technique. Urology 2008;72:847–9.
El-Saman AM. Retropubic balloon vaginoplasty for
management of Mayer-Rokitansky-Kuster-Hauser syndrome.
Fertil Steril 2009; (Epub ahead of print).
Dua HS, Azuara-Blanca A. Amniotic membrane
transplantation. Br J Opthalmol 1999;83:748–52.