Meutia Alfa Putri, Kouwagam Anggrainy Dwifitriana, Djusad Suskhan, Hakim Surahman, Priyatini Tyas, Harzif Achmad Kemal
Division of Urogynecology, Reconstruction and Aesthetic Surgery Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia/ Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Division of Urogynecology, Reconstruction and Aesthetic Surgery Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia/ Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Int J Surg Case Rep. 2023 May;106:108157. doi: 10.1016/j.ijscr.2023.108157. Epub 2023 Apr 11.
Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a rare condition characterized by congenital aplasia of the uterus and upper two-third vagina with normal secondary characteristics. Treatment of this condition consists of non-surgical and surgical management. After nonsurgical Frank method, neovaginal canal may be formed but sometimes the vaginal length may not be adequate to facilitate normal sexual intercourse.
A 27-year-old woman, sexually active, complained about the difficulty of sexual intercouse. The patient was diagnosed with vaginal agenesis and uterine dysgenesis with normal secondary sexual characteristics and chromosome (46, XX). The patient has had nonsurgical treatment by Frank method for 6 years and as a result we found a 5 cm-vaginal indentation but she still complaint of pain and discomfort during intercourse. Laparoscopy proximal neovaginoplasty using autologous peritoneal graft was performed to add the proximal vaginal length.
In our case, the patient may have a short vagina as the result from inadequate Frank method dilatation. This may cause dyspareunia and discomfort to her sexual partner. Therefore, laparoscopic proximal neovaginaplasty and uterine band excision were carried out to correct the anatomical restriction and improve her sexual function.
Laparoscopic proximal neovaginoplasty is a surgical method to increase proximal vaginal length by using autologous peritoneal graft which shows excellent result. This procedure should be considered in MRKH syndrome patients with unsatisactory nonsurgical treatment result.
迈耶-罗基坦斯基-库斯特-豪泽（MRKH）综合征是一种罕见疾病，其特征为子宫和阴道上三分之二先天性发育不全，而第二性征正常。该疾病的治疗包括非手术和手术管理。采用非手术弗兰克方法后，可能会形成新阴道管，但有时阴道长度可能不足以便利正常性交。
一名27岁性活跃女性，主诉性交困难。患者被诊断为阴道发育不全和子宫发育异常，第二性征和染色体正常（46, XX）。患者采用弗兰克方法进行非手术治疗6年，结果发现阴道有5厘米的凹陷，但她在性交时仍抱怨疼痛和不适。遂进行腹腔镜近端阴道成形术，使用自体腹膜移植以增加近端阴道长度。
在我们的病例中，患者可能因弗兰克方法扩张不足导致阴道较短。这可能会给她和性伴侣带来性交困难和不适。因此，进行了腹腔镜近端阴道成形术和子宫带切除术以纠正解剖学限制并改善其性功能。
腹腔镜近端阴道成形术是一种通过使用自体腹膜移植增加近端阴道长度的手术方法，效果良好。对于非手术治疗效果不理想的MRKH综合征患者，应考虑该手术。
