Vaginal aplasia and reconstruction.

Congenital vaginal agenesis, with a prevalence of 1 in 4000 females, occurs mainly as a feature of the Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Management of patients with MRKH syndrome includes, along with the proper psychological support, the creation of a neovagina to give them the opportunity to have a normal sexual life. Both surgical and non-surgical techniques have been suggested during the past century, for neovagina creation. Among them, the most widespread non-surgical techniques performed are the Frank technique and its modification by Ingram, while the surgical techniques include the McIndoe operation, the Vechietti procedure and its laparoscopic modification and the Williams vaginoplasty and its Creatsas modification. The Creatsas vaginoplasty is a simple, fast and safe technique that has been performed in 178 patients in our Institution over the past 22 years and has provided excellent results in the vast majority of patients.