A new laparoscopic procedure for creation of a neovagina in Mayer-Rokitansky-Kuster-Hauser syndrome.

OBJECTIVE

To evaluate the results of a new laparoscopic technique for the creation of a neovagina in women with Rokitansky syndrome.

DESIGN

Open noncomparative clinical study.

SETTING

Tertiary care center.

PATIENT(S): Fourteen patients with Rokitansky syndrome, aged 15 to 34 years, desiring to have sexual relations.

INTERVENTION(S): The patients underwent creation of a neovagina at laparoscopy by a modification of Vecchietti's technique.

MAIN OUTCOME MEASURE(S): At the clinical examinations performed during the follow up (ranging from 6 to 24 months), the patients reported the frequency, satisfaction, and any difficulties found at intercourse. At each examination, the depth and diameter of the neovagina was determined. The characteristics of the neovaginal mucosa were investigated by vaginoscopy.

RESULTS(S): No intraoperative and postoperative complications were observed. The patients considered the discomfort caused by the Vecchietti's device and the daily tractions acceptable. In all the patients the mucosa was pink, trophic, and moist 3 months after the operation. Two fingers were introduced easily into the neovagina in all cases, and the mean length was 8.1 +/- 1.1 cm. All but one patient defined their sexual intercourse as satisfying within 6 months from the intervention.

CONCLUSION(S): In light of the results obtained in the present series, we consider that, because of its efficacy, rapidity, and safety, the laparoscopic surgical method used by us may be suggested as the treatment of choice to correct Rokitansky syndrome.