The laparoscopic Vecchietti technique for vaginal agenesis

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Published Jun 24, 2013
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Vol. 91 No. 6 (2013): Issue Jun 2013

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Moez Kdous
Anis Chaker
Monia Ferchiou
Fethi Zhioua

Abstract

aim: To evaluate feasibility and surgical long term, anatomic and functional results of the laparoscopic Vecchietti procedure to treat women with vaginal agenesis.
methods: We reported six cases of patients with a Mayer-Rokitansky-Küster-Hauser syndrome. The surgical procedure was the same for all patients. The results have been evaluated on the operative time, the intra and postoperative complications, the antalgic drugs consumption, the transit recovery, the hospital stay, the neovagina length, and the post operative sexual satisfaction.
results: The mean operative time was 77.5 minutes. The mean paracetamol consumption was: 9.8 g. The mean transit recovery, and hospital stay were: 2 days, 9.8 days, respectively. No intra or postoperative complication occurred. The mean neovagina length evaluated at one year follow-up visit was 7.5 cm. Five patients have regular sexual activity. Three of them reported sexual satisfaction and showed having orgasm (clitoral: 3 cases, clitoral and vaginal: 2 cases). The 2 remaining patients reported dyspareunia. The global satisfaction index was of 71.6%.
Conclusion: This surgical technique appeared to be safe, effective and reproducible. It allowed to obtain a neovagina with enough length and have encouraging results on sexual functioning Laparoscopy reduces the psychological and aesthetic consequences of surgery, especially for these young patients already distressed by their malformation.  

Keywords:

Mayer-Rokitansky-Küster-Hauser syndrome; Laparoscopy; Neovagina

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References

  1. Evans PN, Poland NL, Boving RL. Vaginal malformations. Am J Obstet Gynecol 1981;141:910-20.
  2. Frank RT. The formation of an artificial vagina without operation. Am. J. Obstet. Gynecol. 938;35:1053-5.
  3. Vecchietti G. Neovagina nella sindrome di Rokitansky-Kuster- Hauser. Attual. Ostet. Ginecol. 1965;11:131-47.
  4. Fedele L, Busacca M, Candiani M, Vignali M. Laparoscopic creation of a neovagina in Mayer-Rokitansky-Kuster-Hauser syndrome by modification of Vecchietti's operation. Am J Obstet Gynecol 1994;171:268-9.
  5. Darai E, Toullalan O, Besse O, Poriton L, Delga P. Anatomic and functional results of laparoscopic-perineal neovagina construction by sigmoid colpoplasty in women with Rokitansky's syndrome. Hum Reprod 2003, 18: 2454-59.
  6. Borruto F, Camoglio FS, Zampieri N, Fedeli L. The laparoscopic Vecchietti technique for vaginal agenesis. Int J Gynecol Obstet 2007, 98: 15-19.
  7. Ozgur H, Armali H, Grody T. Laparoscopic Vecchietti procedure. Improving on an indispensable method: noval variation on an essential technique may benefit surgeons and their patients. Am J Obstet Gynecol 2008, 199: 713-14.
  8. Fedele L, Frontino G, Zurawin RK. Laparoscopic Vecchietti procedure using new traction device. J Min Inv Gynecol 2009, 16: 99.
  9. Gomez NA, Uppal S, Shehu G, Chatwani A, Quintero Arias C. Laparoscopic creation of neovagina by Vecchietti's technique. J Min Inv Gynecol 2011, 18: 60-61.
  10. Keckstein J, Buck G, Sasse V, Tuttlies FR, Ulrich U. laparoscopic creation of a neovagina: modified Vecchietti method. Endosc Surg 1995, 3: 93-95.
  11. Khaler E, Fatthy H. Laparoscopic Vecchietti vaginoplasty. J Am Assoc Gynecol laparoscopists 1999, 6: 179-82.
  12. Csermely T, Halvax L, Sarkany A, et al. Sexual function after modified laparoscopic Vecchietti's vaginoplasty. J Ped Adol Gynecol 2011, 24:147-52.