Journal of Isfahan Medical School

Journal of Isfahan Medical School

Examining the Results of Vaginoplasty Surgery Using Sigmoid Graft in the Treatment of Vaginal Agenesis, A Retrospective Cohort Study

Document Type : Original Article(s)

Authors
Salahedin Delshad 1
Balal Delshad 2
Soghra Taheri 3
Kajal Yadegari 3
Mahsa Khoshnam rad 4
1 General Surgeon and Pediatric Surgeon, Maryam Hospital, Karaj, Iran
2 General Surgeon and Breast Surgery Specialist, Maryam Hospital, Karaj, Iran
3 BSc in Operation Room, Maryam Hospital, Karaj, Iran
4 PhD, Midwifery and Reproductive Health Department, Alborz University of Medical Sciences, Alborz, Iran
10.48305/jims.v42.i755.0050
Abstract
Background: Vaginal agenesis is one of the important abnormality consequences of mullein duct formation defects in the reproductive health system. It's mainly seen in Myer-Rakitaneskia syndrome. The vagina agenesis can be corrected by neo- vagina surgery.
Methods: The seventy- two patients affected with vagina agenesis, who have surgeries by sigmoid vaginoplasty in Maryam hospital in Alborz province, participated in this retrospective study during 2018-2023. Patients were followed between 3 months to 4.5 years after surgery for operation outcomes.
Findings: The minimum age of the patient was 13, and the oldest was 40. Seven of the patients had Mc-Indoe's surgery history. The adverse outcomes of surgery were: bleeding at 5 (6.9%), pain at 3(4.1%), scant vaginal discharge at 3(4.1%), surgery site infection at 2 (2.7%), Vaginal tightness at 2(2.7%), and rectovaginal fistula at 3 (4.1%), respectively. At six and twelve months after the surgery, only two patients had complained of vaginal discharge. After sigmoid vaginoplasty surgery, five patients have successfully married. All patients had sexual function satisfaction.
Conclusion: Considering the usefulness of surgery with sigmoid graft in vaginal agenesis patients, the possibility of creating a suitable channel for sexual activity, few complications, and the possibility of communicating for up to 3 weeks after discharge, vaginoplasty with sigmoid graft is an appropriate method for treating patients without a vagina.

Highlights

Salahedin Delshad: PubMed, Google Scholar

Mahsa Khoshnam-Rad: PubMed, Google Scholar

Keywords
Vaginoplasty
Vagina agenesis
Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome
Sigmoid vaginoplasty

Subjects

  1. Liszewska-Kapłon M, Strózik M, Kotarski Ł, Bagłaj M, Hirnle L. Mayer-Rokitansky-Küster-Hauser syndrome as an interdisciplinary problem. Adv Clin Exp Med 2020; 29(4): 505-11.
  2. Nakhal RS, Creighton SM. Management of vaginal agenesis. J Pediatr Adolesc Gynecol 2012; 25(6): 352-7.
  3. Mungadi IA, Ahmad Y, Yunusa GH, Agwu NP, Ismail S. Mayer-rokitansky-kuster-hauser syndrome: surgical management of two cases. J Surg Tech Case Rep 2010; 2(1): 39-43.
  4. Herlin MK, Petersen MB, Brännström M. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: a comprehensive update. Orphanet J Rare Dis 2020; 15(1): 214.
  5. Londra L, Chuong FS, Kolp L. Mayer-Rokitansky-Kuster-Hauser syndrome: a review. Int J Womens Health 2015; 7: 865-70.
  6. Carrard C, Chevret-Measson M, Lunel A, Raudrant D. Sexuality after sigmoid vaginoplasty in patients with Mayer-Rokitansky-Küster-Hauser syndrome. Fertil Steril 2012; 97(3): 691-6.
  7. Kapoor R, Sharma DK, Singh KJ, Suri A, Singh P, Chaudhary H, et al. Sigmoid vaginoplasty: long-term results. Urology 2006; 67(6): 1212-5.
  8. Dabaghi S, Zandi M, Ilkhani M. Sexual satisfaction in patients with Mayer-Rokitansky-Küster-Hauser syndrome after surgical and non-surgical techniques: a systematic review. Int Urogynecol J 2019; 30(3): 353-62.
  9. Delshad S, Delshad B, Mogheimi P. Postoperative outcomes of sigmoid colon vaginoplasty for vaginal agenesis: A randomized controlled trial. Ann Med Surg (Lond) 2022; 78: 103833.
  10. Michala L, Cutner A, Creighton SM. Surgical approaches to treating vaginal agenesis. BJOG. 2007;114(12):1455-9.
  11. Morgan EM, Quint EH. Assessment of sexual functioning, mental health, and life goals in women with vaginal agenesis. Arch Sex Behav 2006; 35(5): 607-18.
  12. Khen-Dunlop N, Lortat-Jacob S, Thibaud E, Clément-Ziza M, Lyonnet S, Nihoul-Fekete C. Rokitansky syndrome: clinical experience and results of sigmoid vaginoplasty in 23 young girls. J Urol 2007; 177(3): 1107-11.
  13. Pangastuti N, Rahman MN, Handaya AY, Setyawan N, Sofii I, Barmawi A. How is Vaginal Function in Patients with A History of Sigmoid Vaginoplasty Surgery? Mal J Med Health Sci 2020; 16(3): 18-23.
  14. McQuillan SK, Grover SR. Dilation and surgical management in vaginal agenesis: a systematic review. Int Urogynecol J 2014; 25(3): 299-311.
  15. Garcia-Roig M, Castellan M, Gonzalez J, Gorin MA, Cruz-Diaz O, Labbie A, et al. Sigmoid vaginoplasty with a modified single Monti tube: a pediatric case series. J Urol 2014; 191(5): 1537-42.
  16. Djordjevic ML, Bizic M, Stojanovic B, Ivanovski O, Purohit R. Treatment of Urethral Intercourse and Impact on Female Sexual Function. Sex Med 2022; 10(4): 100534.
  17. Urbanowicz W, Sulislawski J, Wolnicki M, Mycek R, Soltysiak P, Maniecka K. Laparoscopic vaginal reconstruction using an isolated sigmoid segment: a five-year experience. J Pediatr Urol 2007; 3: S70.
  18. Hensle TW, Shabsigh A, Shabsigh R, Reiley EA, Meyer-Bahlburg HF. Sexual function following bowel vaginoplasty. J Urol 2006; 175(6): 2283-6.
  19. Imparato E, Alfei A, Aspesi G, Meus AL, Spinillo A. Long-term results of sigmoid vaginoplasty in a consecutive series of 62 patients. Int Urogynecol J Pelvic Floor Dysfunct 2007; 18(12): 1465-9.
  20. Rawat J, Ahmed I, Pandey A, Khan TR, Singh S, Wakhlu A, et al. Vaginal agenesis: Experience with sigmoid colon neovaginoplasty. J Indian Assoc Pediatr Surg 2010; 15(1): 19-22.
  21. Karateke A, Haliloglu B, Parlak O, Cam C, Coksuer H. Intestinal vaginoplasty: seven years' experience of a tertiary center. Fertil Steril 2010; 94(6): 2312-5.
Journal of Isfahan Medical School
Volume 42, Issue 755
3rd Week, April
March and April 2024
Pages 50-57

  • Receive Date 07 January 2024
  • Revise Date 23 April 2024
  • Accept Date 15 May 2024