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Y-C Li, H-H Kuo, M-H Cheng, C-L Li
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November 2015: Journal of Minimally Invasive Gynecology
Lorenz Kuessel, René Wenzl, Marie-Louise Marschalek, Georg Slavka, Daniela Doerfler, Heinrich Husslein
OBJECTIVE: To provide a review of the literature regarding this technique as well as a step-by-step description with the goal of increasing its use as a safe surgical option. Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is characterized by vaginal agenesis and a variety of mullerian duct anomalies. To date, a variety of procedures have been described for creating a neovagina, but the best treatment remains debated. The Wharton-Sheares-George method, a minimally invasive surgical approach for the creation of a neovagina, is remarkably simple to perform...
September 24, 2016: Fertility and Sterility
Mark-Bram Bouman, Wouter B van der Sluis, Marlon E Buncamper, Müjde Özer, Margriet G Mullender, Wilhelmus J H J Meijerink
BACKGROUND: In young transgender women previously treated with puberty-suppressing hormones, penoscrotal hypoplasia can make penoscrotal inversion vaginoplasty unfeasible. The aim of this study was to prospectively assess surgical outcomes and follow-up of total laparoscopic sigmoid vaginoplasty as primary reconstruction in a cohort of transgender women with penoscrotal hypoplasia. METHODS: Baseline demographics, surgical characteristics, and intraoperative and postoperative complications of all performed total laparoscopic sigmoid vaginoplasty procedures were prospectively recorded...
October 2016: Plastic and Reconstructive Surgery
Wouter B Van der Sluis, Mark-Bram Bouman, Marlon E Buncamper, Margriet G Mullender, Wilhelmus J Meijerink
BACKGROUND: Vaginal (re)construction can greatly improve the quality of life of indicated patients. If primary vaginoplasty fails, multiple surgical approaches exist for revision. The authors compared surgical results of laparoscopic intestinal versus full-thickness skin graft revision vaginoplasty. METHODS: A retrospective chart review of patients who underwent revision vaginoplasty at the authors' institution was conducted. Patient demographics, surgical characteristics, complications, hospitalization, reoperations, and neovaginal depth for both surgical techniques were recorded and compared...
October 2016: Plastic and Reconstructive Surgery
Fang Shen, Xu-Yin Zhang, Chu-Yang Yin, Jing-Xin Ding, Ke-Qin Hua
STUDY QUESTION: What is the difference in vaginal-length gain and resumption of menstruation following cervicovaginal reconstruction using split-thickness skin (STS) graft versus small intestinal submucosa (SIS) graft for patients with congenital vaginal and cervical aplasia? SUMMARY ANSWER: No difference was found in the number of patients who resumed menstruation between the two groups; however, significantly greater vaginal-length gain was found in the STS group...
September 22, 2016: Human Reproduction
Hazem Orabi, Alexandre Rousseau, Stephane Bolduc
Many diseases necessitate the substitution of vaginal tissues. Current replacement therapies are associated with many complications. In this study, we aimed to create bioengineered neovaginas with the self-assembly technique using autologous vaginal epithelial (VE) and vaginal stromal (VS) cells without the use of exogenous materials and to document the survival and incorporation of these grafts into the tissues of nude female mice. Epithelial and stromal cells were isolated from vaginal biopsies. Stromal cells were driven to form collagen sheets, 3 of which were superimposed to form vaginal stromas...
August 1, 2016: Translational Research: the Journal of Laboratory and Clinical Medicine
Guilherme Lang Motta, Patric Machado Tavares, Lucas Medeiros Burttet, Milton Berger, Brasil Silva Neto, Tiago Elias Rosito
OBJECTIVE: To present a novel technique in reconstructive urology for congenital vaginal agenesis using a full-thickness mesh skin graft and to evaluate the functional capacity for maintenance of satisfactory intercourse. METHODS: From January 2009 to August 2015, seven patients diagnosed with vaginal agenesis underwent vaginoplasty using a full-thickness mesh graft from lower abdominal skin. Herein, the authors describe the technique and initial results in adult patients...
August 9, 2016: Urology
M Sirakov, E Tomova
Mayer-Rokitansky-Küster-Hauser syndrome is a part of the group of abnormalities known as "Anomalies of the fusion of the Müllerian ducts". It is characterized by normal development of breasts and hairs, normal appearance of external genitalia, normal feminine genotype (46XX), normal FSH, LH, E₂ and Test. levels, normal ovaries and congenital absence of uterus and the whole or the upper two thirds of the vagina. It is observed in about 15% of the cases with primary amenorrhea and the incidence is about 1:4500-6000...
2016: Akusherstvo i Ginekologii︠a︡
Mark-Bram Bouman, Wouter B van der Sluis, Leonora E van Woudenberg Hamstra, Marlon E Buncamper, Baudewijntje P C Kreukels, Wilhelmus J H J Meijerink, Margriet G Mullender
INTRODUCTION: Puberty-suppressing hormonal treatment may result in penoscrotal hypoplasia in transgender women, making standard penile inversion vaginoplasty not feasible. For these patients, intestinal vaginoplasty is a surgical alternative, but knowledge on patient-reported postoperative outcomes and quality of life is lacking. AIMS: To assess patient-reported functional and esthetic outcomes, quality of life, satisfaction, and sexual well-being after primary total laparoscopic intestinal vaginoplasty in transgender women...
September 2016: Journal of Sexual Medicine
Oya Soylu Karapınar, Mustafa Özkan, Ayşe Güler Okyay, Hanifi Şahin, Kenan Serdar Dolapçıoğlu
OBJECTIVE: Retrospective analysis of cases that have undergone neovagina operation because of congenital vaginal agenesis was objected. MATERIAL AND METHODS: Seven cases applying with the complaints of primary amenorrhea or inability to have sexual intercourse were in the study. The cases were diagnosed with congenital vaginal agenesis and operated at Mustafa Kemal University Training and Research Hospital between 2011 and 2014. Vaginoplasty by the modified McIndoe method was performed in all cases...
2016: Journal of the Turkish German Gynecological Association
Mingle Zhang, Suolin Li, Xianghua Huang, Hui Du, Chengshu Wang, Lijuan Zhang, Yanan Li, Jingkun Zhang, Zhenhai Wang
OBJECTIVE: To validate the technical feasibility and anatomical and functional outcomes of transumbilical single-incision laparoscopic (SIL) sigmoid vaginoplasty hybrid transperineal approach in women with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. METHODS: Twenty-five patients who underwent transumbilical SIL sigmoid vaginoplasty hybrid transperineal approach were retrospectively evaluated. Operation time and postoperative complications were analyzed. The length and breadth of the neovagina, lubrication and the Female Sexual Function Index were evaluated to assess the anatomical and functional outcomes of the surgery...
September 2016: International Urology and Nephrology
Kazumi Takahashi, Eri Nakamura, Shingo Suzuki, Mari Shinoda, Yoshihiro Nishijima, Yuko Ohnuki, Akane Kondo, Takashi Shiina, Takahiro Suzuki, Shunichiro Izumi
OBJECTIVE: Several surgical techniques have been described for creating a neovagina in patients with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome, however as yet there is no standardized treatment. The aim of this report is to assess anatomic and functional outcomes after the laparoscopic Davydov procedure for the creation of a neovagina in patients with MRKH syndrome. METHODS: Seven patients with MRKH syndrome underwent the laparoscopic Davydov technique from January 2005 to August 2010...
2016: Tokai Journal of Experimental and Clinical Medicine
Joke Hellinga, Patrick C K H Khoe, Boudewijn van Etten, Patrick H J Hemmer, Klaas Havenga, Martin W Stenekes, Yassir Eltahir
BACKGROUND: The extralevator abdominoperineal excision (ELAPE) procedure creates an extensive soft tissue defect of the pelvic floor. It has been suggested that primary reconstruction reduces the risk of wound infection and delayed wound healing in this high-risk area. Use of myocutaneous flaps or omentoplasty are associated with functional limitations and complications. We performed the perineal variant of the lotus petal flap, which was originally described for vulvar reconstruction...
June 23, 2016: Annals of Surgical Oncology
D Sawan, N Sahly, H Abduljabbar, A A Rouzi
The authors describe a case with androgen insensitivity syndrome (AIS) who underwent the laparoscopic Vecchietti procedure for creation of a neovagina. Postoperatively, the patient achieved anatomic success, with a vaginal length of about eight cm, and she was advised to use vaginal dilators after discharge. The patient reported improved sexual function, but presented about six months later for shortening of her vagina and difficult vaginal intercourse. Physical examination revealed an obliterated vaginal canal about two cm long...
2016: Clinical and Experimental Obstetrics & Gynecology
Joseph Nassif, Joe Eid, Pierre Akiki, Ali Khalil, Ghina Ghazeeri
Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disorder characterized by uterine aplasia and aplasia of the upper part of the vagina. It presents with primary amenorrhea in a 46, XX individual. In this paper, we report the cases of two patients with MRKH syndrome treated with the laparoscopic modified Vecchietti technique using the optimized new instruments. A neovagina was successfully created in these two patients. This minimally invasive technique offers improvements in terms of operative time, complications, and functionality...
April 2016: Surgical Technology International
Mathias Neron, Gwenaël Ferron, Pierre Vieille, Vincent Letouzey, Brigitte Fatton, Renaud de Tayrac
INTRODUCTION AND HYPOTHESIS: Neovaginal prolapse (NP) is a rare event as few cases have been reported in the literature. Its management is complex and depends on the initial pathology, the vaginoplasty technique and the patient's history. We present a review the literature on this rare event. METHODS: We describe the case of a 72-year-old woman who presented with NP 1 year after pelvic exenteration and radiotherapy for recurrent cervical carcinoma associated with vaginal reconstruction by shaped-tube omentoplasty...
April 2, 2016: International Urogynecology Journal
Wouter B van der Sluis, Mark-Bram Bouman, Nanne K H de Boer, Marlon E Buncamper, Adriaan A van Bodegraven, E Andra Neefjes-Borst, Baudewijntje P C Kreukels, Wilhelmus J H J Meijerink, Margriet G Mullender
INTRODUCTION: Intestinal vaginoplasty with a sigmoid colon or ileal segment is an established surgical technique for vaginal reconstruction. Little has been reported on long-term (functional) outcome and postoperative quality of life. AIMS: To assess the surgical and long-term psychological outcomes of secondary intestinal vaginoplasty performed from 1970 through 2000 in transgender women. METHODS: Transgender women who underwent intestinal vaginoplasty from 1970 through 2000 were identified from our hospital registry...
April 2016: Journal of Sexual Medicine
Luz Angela Torres-de la Roche, Rajesh Devassy, Sreelatha Gopalakrishnan, Maya Sophie de Wilde, Anja Herrmann, Angelika Larbig, Rudy Leon De Wilde
Vaginal agenesis is a congenital anomaly that affects the life of one of each four thousand women around the world. There is a trend that patients request immediate surgical correction, instead of passive vaginal dilatation. Therefore a differentiated counselling should be provided. We present a comparative chart, based on published evidence, with aspect to the available techniques, which will facilitate the decision-making process in the clinical practice. From our point of view, the best results are achieved with techniques that combine the advantages of the minimal-invasive surgery with those derived of the use of peritoneum as covering tissue of the neovagina...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Rahul Janak Sinha, Ved Bhaskar, Seema Mehrotra, Vishwajeet Singh
Vaginal agenesis occurs in approximately 1:5000 live female births. It results from failure of the sinovaginal bulbs to develop and form the vaginal plate. Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH) is the most common cause of vaginal absence followed by complete or partial androgen insensitivity syndrome. Treatment of these patients encompasses a spectrum from simple non-operative dilation to the more complicated surgical creation of a neovagina. We present a case of a patient with testicular feminising syndrome who was reared as a female and underwent bilateral gonadal excision and sigmoid vaginoplasty...
2016: BMJ Case Reports
Tomoko Nagata, Aiko Kawano, Makiko Koyama, Tomomi Nakamura, Fumiki Hirahara, Tadaaki Nakajima, Tomomi Sato, Hideya Sakakibara
OBJECTIVE: To evaluate the effect of FGF on epithelialization of neovagina in patients with Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) who underwent vaginoplasty. DESIGN: Observational study SETTING: University hospital. PATIENTS: Seven patients with MRKHS. INTERVENTIONS: Cytological examination was done on vaginal smear samples from the site of completed epithelialization, and tissue was collected from the epithelialized part for histological evaluation...
December 11, 2015: Journal of Pediatric and Adolescent Gynecology
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