Wendy Kuohung1, Sharon R Thompson, Marc R Laufer. 1. Department of Obstetrics, Boston University School of Medicine, and Brigham and Women's Hospital, Boston, Massachusetts, USA.
Abstract
BACKGROUND: Both autologous and synthetic tissue have been used to create a neovagina in women with Mayer-Rokitansky-Küster-Hauser syndrome. Despite reports on many different techniques, the ideal method of vaginoplasty has not been firmly established. CASE: A 33-year-old woman with Mayer-Rokitansky-Küster-Hauser syndrome had been unsuccessful in using vaginal dilators for the creation of a functional vagina with the Frank technique due to pain and vulvar lichen sclerosis. She thus elected to undergo vaginoplasty by a modified McIndoe procedure using acellular human dermal allograft material. Both the surgery and immediate postoperative course were uncomplicated. Vaginal apex stenosis resulted from inadequate dilatation in the weeks following surgery since the patient experienced pain with dilator use. CONCLUSION: The use of dermal allograft material instead of a split-thickness autologous skin graft is a simple and less invasive method of constructing a neovagina. Due to the many potential advantages of this technique, further investigation is warranted to optimize long-term outcomes of vaginoplasty using this method.
BACKGROUND: Both autologous and synthetic tissue have been used to create a neovagina in women with Mayer-Rokitansky-Küster-Hauser syndrome. Despite reports on many different techniques, the ideal method of vaginoplasty has not been firmly established. CASE: A 33-year-old woman with Mayer-Rokitansky-Küster-Hauser syndrome had been unsuccessful in using vaginal dilators for the creation of a functional vagina with the Frank technique due to pain and vulvar lichen sclerosis. She thus elected to undergo vaginoplasty by a modified McIndoe procedure using acellular human dermal allograft material. Both the surgery and immediate postoperative course were uncomplicated. Vaginal apex stenosis resulted from inadequate dilatation in the weeks following surgery since the patient experienced pain with dilator use. CONCLUSION: The use of dermal allograft material instead of a split-thickness autologous skin graft is a simple and less invasive method of constructing a neovagina. Due to the many potential advantages of this technique, further investigation is warranted to optimize long-term outcomes of vaginoplasty using this method.