Full-thickness skin graft colpopoiesis in the patient with the mayer-rokitansky-kuster syndrome: a case report

R. М. Izmailov; Измайлов Р. М.; М. Y. Korshunov; Коршунов М. Ю.; Е. I. Sazykina; Сазыкина Е. И.; Е. V. Kaplan; Каплан Е. В.

doi:10.17816/JOWD87599

Full-thickness skin graft colpopoiesis in the patient with the mayer-rokitansky-kuster syndrome: a case report

Authors: Izmailov R.М.¹, Korshunov М.Y.¹, Sazykina Е.I.², Kaplan Е.V.³
Affiliations:
1. Saint Petersburg State Medical University named after I.I. acad. I.P. Pavlova
2. Vsevolozhsk central regional hospital
3. Center for Pelvic Medicine and Advanced Technologies in Gynecological Surgery
Issue: Vol 54, No 5S (2005)
Pages: 99-99
Section: Reviews
URL: https://journals.eco-vector.com/jowd/article/view/87599
DOI: https://doi.org/10.17816/JOWD87599
ID: 87599

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aplasia of the vagina, disabling effect on patients in the absence of a vagina, colpopoiesis, surgical intervention, reconstructive surgery, reconstruction of the vagina, mobilization of the peritoneum according to Davydov

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Introductions. The congenital absence of the vagina has a low incidence but it is a very invalidating condition. The Mayer-Rokitansky-Kuster syndrome represents 90% of all cases of vaginal aplasia. These patients may have an improved quality of sexual life once a neovagina is constructed. Four techniques of colpopoiesis are most commonly used: Abbe-Wharton-McIndoe procedure with use of split-thickness skin graft, a full-thickness skin graft neovagina, a Vecchietti procedure and a colon colpopoiesis. There are some other procedures including advancement of peritoneum as per Davidov or in combination with transposition skin flaps from labia minora as per Friedberg and Knapsten. All of them have some advances and faults, and the choice of procedure depends on many factors, including patients’ wishes.

Objectives. To present a case of successful colpopoiesis using full-thickness skin graft.

Case report. An 18-year-old woman with the Mayer-Rokitansky-Kuster syndrome attended to the hospital wishing to get able to have a sexual life. She was informed about most of the current methods used for neovagina reconstruction, including conservative treatment options, and was asked to choose the most appropriate for her. She preferred the full-thickness skin graft technique. The U-shaped incision of vulvar skin was made in the area of the future introitus. After performing a recto-vesical dissection, three skin grafts were obtained from abdomen and left inner thigh and properly prepared. Then skin grafts were folded around the vaginal mold and the graft edges were sewn together with 4-0 absorbable sutures. The mold was then inserted into the prepared recto-vesical space. The edges of the skin graft were attached to the vulvar skin. The U-shaped flap of excised vulvar skin was used to create a posterior furshette. This trick is aimed to diminish dyspareunia in the future life. The mold was left in the neovagina for 10 days, then it was got out and new vagina was revised, showing good engraftment. The patient was instructed to keep the vaginal dilator in her neovagina constantly for 2 months. Now, 3 months after the operation, the patient feels good. Sexual life will be permitted after a half-year postoperatively. The size and elastic qualities of neovagina are sufficient.

Conclusions. The results of colpopoiesis with fullthickness skin graft are good in this case, showing that there is a good alternative to a more invasive colon colpopoiesis.