Cargando…

Introducing Modified Technique of Combined Vaginal and Laparoscopic Approach for Creation of Neovagina

INTRODUCTION AND IMPORTANCE: There are many methods described in the literature for creating a functional neovagina. However, the best method has yet to be determined. In our urogynecology training center, neovaginoplasty was usually performed by vaginal approach using modified McIndoe technique wit...

Descripción completa

Detalles Bibliográficos
Autores principales: Meutia, Alfa P., Harzif, Achmad Kemal, Priyatini, Tyas, Moegni, Fernandi, Hakim, Surahman, Djusad, Suskhan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10149330/
https://www.ncbi.nlm.nih.gov/pubmed/37087929
http://dx.doi.org/10.1016/j.ijscr.2023.108164
_version_ 1785035142904938496
author Meutia, Alfa P.
Harzif, Achmad Kemal
Priyatini, Tyas
Moegni, Fernandi
Hakim, Surahman
Djusad, Suskhan
author_facet Meutia, Alfa P.
Harzif, Achmad Kemal
Priyatini, Tyas
Moegni, Fernandi
Hakim, Surahman
Djusad, Suskhan
author_sort Meutia, Alfa P.
collection PubMed
description INTRODUCTION AND IMPORTANCE: There are many methods described in the literature for creating a functional neovagina. However, the best method has yet to be determined. In our urogynecology training center, neovaginoplasty was usually performed by vaginal approach using modified McIndoe technique with amnion graft and >7 days hospitalization was required. However, we tried to combine both vaginal and laparoscopic modified technique of neovaginoplasty to improve the functional and surgical outcome as well as shortened hospital stay. CASE PRESENTATION: A 27-year-old woman came to our center with a chief complaint of primary amenorrhea and she was diagnosed with vaginal agenesis as part of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. She underwent neovaginaplasty using a combined vaginal and laparoscopic approach with autologous peritoneal graft. Patient was discharged the next day. The follow up result (6-24 months) was excellent with total vaginal length was 8 cm and FSFI score 34.5. CLINICAL DISCUSSION: The use of peritoneal graft using a laparoscopic approach for vaginal reconstruction was chosen in this case after proper counseling with the type of vaginal mucosal lining as the primary consideration. We combined our routine vaginal approach technique with laparoscopic approach to provide an autologous peritoneal graft and considered modifying the technique by extending the peritoneal dissection laterally to facilitate mobilization of the peritoneum to cover the whole surface of neovagina. CONCLUSION: Combined vaginal and laparoscopic modified technique of neovagina creation may present as treatment option for MRKH patients with excellent anatomical and functional result, minimal surgical complication and shorter hospital stay.
format Online
Article
Text
id pubmed-10149330
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-101493302023-05-02 Introducing Modified Technique of Combined Vaginal and Laparoscopic Approach for Creation of Neovagina Meutia, Alfa P. Harzif, Achmad Kemal Priyatini, Tyas Moegni, Fernandi Hakim, Surahman Djusad, Suskhan Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: There are many methods described in the literature for creating a functional neovagina. However, the best method has yet to be determined. In our urogynecology training center, neovaginoplasty was usually performed by vaginal approach using modified McIndoe technique with amnion graft and >7 days hospitalization was required. However, we tried to combine both vaginal and laparoscopic modified technique of neovaginoplasty to improve the functional and surgical outcome as well as shortened hospital stay. CASE PRESENTATION: A 27-year-old woman came to our center with a chief complaint of primary amenorrhea and she was diagnosed with vaginal agenesis as part of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. She underwent neovaginaplasty using a combined vaginal and laparoscopic approach with autologous peritoneal graft. Patient was discharged the next day. The follow up result (6-24 months) was excellent with total vaginal length was 8 cm and FSFI score 34.5. CLINICAL DISCUSSION: The use of peritoneal graft using a laparoscopic approach for vaginal reconstruction was chosen in this case after proper counseling with the type of vaginal mucosal lining as the primary consideration. We combined our routine vaginal approach technique with laparoscopic approach to provide an autologous peritoneal graft and considered modifying the technique by extending the peritoneal dissection laterally to facilitate mobilization of the peritoneum to cover the whole surface of neovagina. CONCLUSION: Combined vaginal and laparoscopic modified technique of neovagina creation may present as treatment option for MRKH patients with excellent anatomical and functional result, minimal surgical complication and shorter hospital stay. Elsevier 2023-04-13 /pmc/articles/PMC10149330/ /pubmed/37087929 http://dx.doi.org/10.1016/j.ijscr.2023.108164 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Meutia, Alfa P.
Harzif, Achmad Kemal
Priyatini, Tyas
Moegni, Fernandi
Hakim, Surahman
Djusad, Suskhan
Introducing Modified Technique of Combined Vaginal and Laparoscopic Approach for Creation of Neovagina
title Introducing Modified Technique of Combined Vaginal and Laparoscopic Approach for Creation of Neovagina
title_full Introducing Modified Technique of Combined Vaginal and Laparoscopic Approach for Creation of Neovagina
title_fullStr Introducing Modified Technique of Combined Vaginal and Laparoscopic Approach for Creation of Neovagina
title_full_unstemmed Introducing Modified Technique of Combined Vaginal and Laparoscopic Approach for Creation of Neovagina
title_short Introducing Modified Technique of Combined Vaginal and Laparoscopic Approach for Creation of Neovagina
title_sort introducing modified technique of combined vaginal and laparoscopic approach for creation of neovagina
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10149330/
https://www.ncbi.nlm.nih.gov/pubmed/37087929
http://dx.doi.org/10.1016/j.ijscr.2023.108164
work_keys_str_mv AT meutiaalfap introducingmodifiedtechniqueofcombinedvaginalandlaparoscopicapproachforcreationofneovagina
AT harzifachmadkemal introducingmodifiedtechniqueofcombinedvaginalandlaparoscopicapproachforcreationofneovagina
AT priyatinityas introducingmodifiedtechniqueofcombinedvaginalandlaparoscopicapproachforcreationofneovagina
AT moegnifernandi introducingmodifiedtechniqueofcombinedvaginalandlaparoscopicapproachforcreationofneovagina
AT hakimsurahman introducingmodifiedtechniqueofcombinedvaginalandlaparoscopicapproachforcreationofneovagina
AT djusadsuskhan introducingmodifiedtechniqueofcombinedvaginalandlaparoscopicapproachforcreationofneovagina