Novel Minimally Invasive Technique of Neovaginoplasty Using An Absorbable Adhesion Barrier

The objective was to provide a minimally invasive neovaginoplasty technique to construct a nearly physiological vagina to facilitate sexual functioning and appropriate vaginal length in patients with congenital vaginal agenesis. This is a retrospective study at a tertiary care hospital. 52 patients with congenital vaginal agenesis owing to Mayer-Rokitansky-Küster-Hauser syndrome or androgen insensitivity syndrome presented for vaginal reconstruction. Modified McIndoe vaginoplasty was done in all patients between 2010 and 2018using a vaginal mold created with glove, nonadherent petroleum gauze, and Interceed absorbable adhesion barrier (Ethicon, Johnson & Johnson, Somerville, NJ) that was placed in the neovagina space created between the bladder and rectum for 7 days.Operative details, complications, length, and width of the neovagina, and functional outcome were evaluated. The mean operation time was 35 minutes. The mean length of the constructed neovagina was 8.4 cm  ×  3.4 cm at 6 weeks follow-up. Epithelialization was completed by 4 to 6 months. All patients reported satisfactory sexual activity with no pain and good mucosal sensitivity. This modified neovaginoplasty technique is easy to perform, involves painless postoperative dilatations as the cornerstone of treatment, and results in adequate secretion allowing lubrication and acceptable physiologic results.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research