A new method in the treatment of vaginal agenesis with functioning uterus
Sato, H.
Hokkaido Journal of Medical Science 62(3): 476-484
1987
ISSN/ISBN: 0367-6102 PMID: 3610039 Document Number: 295314
A new surgical method to construct the vagina was invented, using the mucosa of the vestibule of vagina in 4 patients with absence of the entire vagina with non-canalization of the cervix and 4 patients with absence of the lower vagina with a well-developed cervical canal. This new method to construct the vagina has the following advantages superior to the usual methods in which tissues and or organs from other parts of the body, such as skin (McIndole) and intestine are used, 1) preservation of fertile uterus, 2) construction of physiological vagina hormonally controlled by ovaries, 3) no occurrence of vaginal reshortening and restenosis, (4) less scar formation on the surface of the body. In both groups of patients, vagina was firstly constructed non-surgically with a depth of 3-6 cm, using vaginal dilators. In the former patients, connective tissues between bladder and rectum was separated, the external os of the uterus, which was observed either by laparotomy or by laporoscopy, was made with Kelly forceps, and the uterine cervix was sutured with the mucosa of the constructed vagina. In the latter group, the operation was much easier than that of the former. The incision made both at the bottom of the non-surgically constructed vagina and at the surface of the hematoma being under the uterine cervix. The mucosa of the vagina was sutured and incised edge of the hematoma. It was concluded from the present study that the new method to construct the vagina enables patients with vaginal agenesis not only to have the physiologically functioning neovagina with leaving less ugly scar on the surface of their bodies but even to have the possibility of normal pregnancy and vaginal delivery.