Laparoscopic vaginoplasty procedure using a modified peritoneal pull-down technique with uterine strand incision in patients with mayer–rokitansky–küster–hauser syndrome: Kisu modification

Iori Kisu, Miho Iida, Kanako Nakamura, Kouji Banno, Tetsuro Shiraishi, Asahi Tokuoka, Keigo Yamaguchi, Kunio Tanaka, Moito Iijima, Hiroshi Senba, Kiyoko Matsuda, Nobumaru Hirao

Research output: Contribution to journalArticlepeer-review

Abstract

Various vaginoplasty procedures have been developed for patients with Mayer–Rokitansky– Küster–Hauser (MRKH) syndrome. Here, we describe a novel laparoscopic vaginoplasty procedure, known as the Kisu modification, using a pull-down technique of the peritoneal flaps with additional structural support to the neovaginal apex using the incised uterine strand in patients with MRKH syndrome. Ten patients with MRKH syndrome (mean age at surgery: 23.9 ± 6.5 years, mean postoperative follow-up period: 17.3 ± 3.7 months) underwent construction of a neovagina via laparoscopic vaginoplasty. All surgeries were performed successfully without complications. The mean neovaginal length at discharge was 10.3 ± 0.5 cm. Anatomical success was achieved in all patients, as two fingers were easily introduced, the neovagina was epithelialized, and the mean neovaginal length was 10.1 ± 1.0 cm 1 year postoperatively. No obliteration, granulation tissue formation at the neovaginal apex, or neovaginal prolapse was recorded. Five of the 10 patients attempted sexual intercourse and all five patients were satisfied with the sexual activity, indicating functional success. Although the number of cases in this case series is few, our favorable experience suggests that the Kisu modification of laparoscopic vaginoplasty procedure is an effective, feasible, and safe approach for neovaginal creation in patients with MRKH syndrome.

Original languageEnglish
Article number5510
JournalJournal of Clinical Medicine
Volume10
Issue number23
DOIs
Publication statusPublished - 2021 Dec 1

Keywords

  • Davydov procedure
  • Mayer–Rokitansky–Küster–Hauser syndrome
  • Neovagina
  • Uterine factor infertility
  • Uterus transplantation
  • Vaginal agenesis
  • Vaginoplasty

ASJC Scopus subject areas

  • Medicine(all)

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