Laparoscopic peritoneal colpopoiesis using uterine rudiments in a patient with Mayer-Rokitansky-Kflster-Hauser syndrome
- Authors: Politova A.K.1, Kira E.F.1, Alexandrova A.D.1, Politova A.A.2
-
Affiliations:
- N.I. Pirogov National Medical and Surgical Center, Ministry of Health of Russia
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
- Issue: No 3 (2021)
- Pages: 196-200
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/249202
- DOI: https://doi.org/10.18565/aig.2021.3.196-200
- ID: 249202
Cite item
Open Access
Access granted
Abstract
Background. The progress of medical science has recently contributed to the practical introduction of high-precision methods for the diagnosis and surgical treatment of internal genital malformations in girls. In this connection, there has been a trend of more frequent detection of this pathology, in particular Mayer-Rokitansky-Kuster- Hauser syndrome that occurs in 1 in 4,000-5,000female births; or the incidence of genital malformations in girls is 3-6% of the total number of gynecological diseases. The most socially unfavorable condition is vaginal aplasia that often requires surgical treatment. Various methods are used in this abnormality to form the vagina from an autologous split-thickness skin graft; from the sigmoid colon or the pelvic peritoneum; traction vaginoplasty with introitus tissues. Case report. The paper describes a clinical case of laparoscopic peritoneal colpopoiesis modified by L.V. Adamyan. The peculiarity of the described operation was the use of uterine rudiments as a plastic material. It is shown that the use of a rudimentary uterine muscle roller on a cut-out peritoneal flap during laparoscopic peritoneal colpopoiesis in Mayer-Rokitansky-Kuster-Hauser syndrome allows one to solve the problem of peritoneal pull-through, tension, and strength in the creation of a neovagina. Conclusion. Laparoscopic peritoneal colpopoiesis refers to technically complex operations. The latter should be performed by a surgeon who has extensive practical experience and high qualification. The creation of the neovagina using the peritoneum is the most effective and relatively safe method of colpopoiesis with a minimum number of intraoperative and postoperative complications. The technical features of the method of laparoscopic peritoneal colpopoiesis, which are described in this article, enable some problems of the standard procedure to be solved.
Full Text
About the authors
Alla K. Politova
N.I. Pirogov National Medical and Surgical Center, Ministry of Health of Russia
Email: all870@mail.ru
Dr. Med. Sci., Professor, Associate Professor, Professor of the Department of Women's Diseases and Reproductive Health of the Institute for the Improvement of Doctors
Eugene F. Kira
N.I. Pirogov National Medical and Surgical Center, Ministry of Health of Russia
Email: profkira33@gmail.com
Honored Scientist of the Russian Federation, Honored Doctor of the Russian Federation, Dr. Med. Sci., Professor, Head of the Department of Women 's Diseases and Reproductive Health of the Institute of Medical Improvement
Anastasia D. Alexandrova
N.I. Pirogov National Medical and Surgical Center, Ministry of Health of RussiaResident of the Gynecology Department of the Center for Women's Health
Alexandra A. Politova
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Email: alexandra.politowa@mail.ru
student
References
- Адамян Л.B., Кулаков В.И., Хашукоева А.З. Пороки развития матки и влагалища. М.: Антидор; 1998. 327 с.
- Лысяк Д.С. Врожденные аномалии развития матки и влагалища. Учебное пособие. Благовещенск; 2017. 80 с.
- Кругляк Д.А., Буралкина Н.А., Ипатова М.В., Батырова З.К., Уварова Е.В. Аплазия влагалища и матки (синдром Майера-Рокитанского-Кюстнера-Хаузера): этиология, патогенетические аспекты и теории формирования порока (обзор литературы). Гинекология. 2018; 20(2): 64-6.
- Кирпатовский И.Д., Уварова Е.В., Адамян Л.В., Угрюмова Л.Ю. Дифференцированный алгоритм выбора метода кольпопоэза. Репродуктивное здоровье детей и подростков. 2008; 5: 31-9.
- Богданов В.Г., Беркович Н.Б. Пластика влагалища. Медицина в Кузбасе. 2007; 6(4): 7-12.
- Давыдов С.Н., Хромов Б.М., Шейко В.З. Атлас гинекологических операций. 2-е изд. Л.: Медицина; 1982. 296с.
- Linder B.J., Gebhart J.B. McIndoe neovagina creation for the management of vaginal agenesis. Int. Urogynecol. J. 2020; 32(2): 453-5. https://dx.doi. org/10.1007/s00192-020-04425-y
- Grimbizis G., Mikos T., Papanokolaou A., Theodoridis T., Tarlatzis B.C. Successful isthmo-neovagina anastomosis after Davydov's colpopoiesis in Mayer-Rokitansky-Küster-Hauser syndrome patients with a functional rudimentary uterine horn. J. Minim. Invasive Gynecol. 2015; 22(1): 142-50. https://dx.doi. org/10.1016/j.jmig.2014.09.003.
- Dargent D., Marchiole P., Giannesi F., Benchaib M., Chevret-Measson M., Mathevet P. Laparoscopic Davydov or laparoscopic transposition of the peritoneal colpopoeisis described by Davydov for the treatment of congenital vaginal agenesis: the technique and its evolution. Gynecol. Obstet. Fertil. 2004; 32(12): 1023-30. https://dx.doi.org/10.1016/j.gyobfe.2004.10.012.
- Bastu E., Akhan S.E., Mutlu M.F, Nehir A., Yumru H., Hocaoglu E. et al. Treatment of vaginal agenesis using a modified McIndoe technique: long-term follow-up of 23 patients and a literature review. Can. J. Plast. Surg. 2012; 20(4): 241-4. https://dx.doi.org/10.1177/229255031202000416.
- Уварова Е.В., Давтян Г.М., Буралкина Н.А., Кругляк Д.А. Формирование неовлагалища путем комплексного неоперативного кольпопоэза у пациенток с синдромом Майера-Рокитанского-Кюстнера-Хаузера. Репродуктивное здоровье детей и подростков. 2014; 6: 40-9.
- Кира Е.Ф., Политова А.К. Робот-ассистированные операции в гинекологии. В кн.: Шевченко Ю.Л., Карпов О.Э., ред. Робот-ассистированная эндовидеохирургия. М.: ДПК Пресс; 2019: 148-83. [Kira E.F., Politova A.K. Robot-assisted operations in gynecology. In book: Robot assisted endovideosurgery under. ed. Yu.L.Shevchenko, O.E. Karpova. M.: DPK Press; 2019: 148-83. (in Russian)].
- Макиян З.Н., Адамян Л.В., Ярыгина Н.К., Асатурова А.В. Гигантская миома маточных рудиментов при аплазии матки и влагалища. Акушерство и гинекология. 2020; 8: 149-52. https:// dx.doi.org/10.18565/aig.2020.8.149-152.
Supplementary files
