A simplified novel laparoscopic formation of neovagina for cases of Mayer-Rokitansky-Küster-Hauser syndrome.

OBJECTIVE

To introduce a simple and easy surgical alternative for formation of a neovagina in patients with Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) that offers reasonable anatomic and functional results.

DESIGN

Technique and instrumentation.

SETTING

University hospital.

PATIENT(S): Two patients with complete vaginal aplasia without a uterus.

INTERVENTION(S): Laparoscopic dissection of the rectovaginal space followed by extraperitoneal traction on a Foley catheter to form a neovagina.

MAIN OUTCOME MEASURE(S): Width and length of the newly formed vagina, and postoperative feasibility of intravaginal sexual intercourse.

RESULT(S): The results were satisfactory (normal length and width of neovagina), with no complications. Both patients began normal sexual activity within 8 to 10 days after the operation.

CONCLUSION(S): Extraperitoneal traction on a laparoscopically inserted Foley catheter seems to be a promising procedure. An endoscopist of average (i.e., not outstanding) experience can perform it at any endoscopic unit without sophisticated equipment or cystoscopy as it is easy to learn and perform. Relatively lower hospital costs, rapid return to work, and early sexual intercourse make it a reasonable procedure.