ABSTRACT
Congenital absence of the vagina is a relatively rare condition most commonly associated
with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. Historically, several reconstructive
techniques have been described to provide for functional vaginal reconstruction on
these patients, both operative and nonoperative. Although there are many advantages
and disadvantages of the various procedures, one experience with the use of split
thickness skin grafts to reconstruct the vagina has produced acceptable functional
results with limited donor site morbidity. Careful planning and timing of this form
of reconstruction can produce predictable results in patients who are nearing sexual
maturity.
KEYWORDS
Congenital absence vagina - vaginal reconstruction - McIndoe procedure
REFERENCES
- 1
Mayer C AJ.
Uber verdoppelungen des uterus und ihre arten nebst bemerkungen uber hasen- scharte
ind wolfsrachen.
J Chir Auger.
1829;
13
525
- 2
Rokitansky K.
Uber die sogenannten Verdoppelun- gen des Uterus.
Med JB Ost Staates.
1838;
26
39-42
- 3
Küster H.
Uterus bipartitus solidus rudimentarius cum vagina solida. Zeitschrift für Geburtshilfe
und Gynäkologie.
Stuttgart.
1910;
67
692-718
- 4
Hauser G A, Schreiner W E.
Mayer-Rokitansky-Kuester syndrome. Rudimentary solid bipartite uterus with solid vagina.
Schweiz Med Wochenschr.
1961;
91
381-384
- 5
Templeman C L, Lam A M, Hertweck S P.
Surgical management of vaginal agenesis.
Obstet Gynecol Surv.
1999;
54
(9)
583-591
- 6
Goldwyn R M.
History of attempts to form a vagina.
Plast Reconstr Surg.
1977;
59
(3)
319-329
- 7
Frank R T.
The formation of an artificial vagina without operation.
Am J Obstet Gynecol.
1938;
35
1053-1055
- 8
Ingram J M.
The bicycle seat stool in the treatment of vaginal agenesis and stenosis: a preliminary
report.
Am J Obstet Gynecol.
1981;
140
(8)
867-873
- 9
ACOG Committee on Adolescent Health Care .
ACOG Committee Opinion No. 355: Vaginal agenesis: diagnosis, management, and routine
care.
Obstet Gynecol.
2006;
108
(6)
1605-1609
- 10
Vecchietti G.
Creation of an artificial vagina in Rokitansky-Küster-Hauser syndrome.
Attual Ostet Ginecol.
1965;
11
(2)
131-147
- 11
Fedele L, Bianchi S, Frontino G, Fontana E, Restelli E, Bruni V.
The laparoscopic Vecchietti's modified technique in Rokitansky syndrome: anatomic,
functional, and sexual long-term results.
Am J Obstet Gynecol.
2008;
198
(4)
377
e1-e6
- 12
Mc Indoe A H, Bannister J B.
An operation for the cure of congenital absence of the vagina.
J Obstet Gynaecol Br Emp.
1938;
45
490-494
- 13
Alessandrescu D, Peltecu G C, Buhimschi C S, Buhimschi I A.
Neocolpopoiesis with split-thickness skin graft as a surgical treatment of vaginal
agenesis: retrospective review of 201 cases.
Am J Obstet Gynecol.
1996;
175
(1)
131-138
- 14
Højsgaard A, Villadsen I.
McIndoe procedure for congenital vaginal agenesis: complications and results.
Br J Plast Surg.
1995;
48
(2)
97-102
- 15
Wee J T, Joseph V T.
A new technique of vaginal reconstruction using neurovascular pudendal thigh flaps:
a preliminary report.
Plast Reconstr Surg.
1989;
83
701-709
- 16
Huang J J, Han C M, Lee C L, Cheng M H.
Pedicled unilateral external pudendal artery perforator flap: a new technique for
reconstruction of congenital vagina agenesis.
Plast Reconstr Surg.
2010;
125
(3)
129e-130e
- 17
Williams E A.
Congenital absence of the vagina: a simple operation for its relief.
J Obstet Gynaecol Br Commonw.
1964;
71
511-512
- 18
Creatsas G, Deligeoroglou E, Christopoulos P.
Creation of a neovagina after Creatsas modification of Williams vaginoplasty for the
treatment of 200 patients with Mayer-Rokitansky-Kuster-Hauser syndrome.
Fertil Steril.
2010;
94
(5)
1848-1852
- 19
Rothman D.
The use of peritoneum in the construction of a vagina.
Obstet Gynecol.
1972;
40
(6)
835-838
- 20
Tamaya T, Imai A.
The use of peritoneum for vaginoplasty in 24 patients with congenital absence of the
vagina.
Arch Gynecol Obstet.
1991;
249
(1)
15-17
- 21
Zhou J H, Sun J, Yang C B, Xie Z W, Shao W Q, Jin H M.
Long-term outcomes of transvestibular vaginoplasty with pelvic peritoneum in 182 patients
with Rokitansky's syndrome.
Fertil Steril.
2010;
94
(6)
2281-2285
- 22
Hendren W H, Atala A.
Use of bowel for vaginal reconstruction.
J Urol.
1994;
152
(2 Pt 2)
752-755
discussion 756-757
- 23
Parsons J K, Gearhart S L, Gearhart J P.
Vaginal reconstruction utilizing sigmoid colon: complications and long-term results.
J Pediatr Surg.
2002;
37
(4)
629-633
- 24
Kwun Kim S, Hoon Park J, Cheol Lee K, Min Park J, Tae Kim J, Chan Kim M.
Long-term results in patients after rectosigmoid vaginoplasty.
Plast Reconstr Surg.
2003;
112
(1)
143-151
Jeffery D FriedmanM.D.
The Methodist Hospital, Institute for Reconstructive Surgery
6560 Fannin, Suite 2200, Scurlock Tower, Houston, TX 77030
eMail: JFriedman@tmhs.org
