A modified neo-vagina procedure in a low resource urogynecological unit: a case report of a 21 year old with Mayer-Rokitansky-Küster-Hauser (mrkh) Syndrome operated at Mbarara referral hospital, Southwestern Uganda

BMC Urology

Case Report

Tom Margolis¹  Musa Kayondo²  Joseph Njagi²  Peter Kivuniike Mukasa³ 

[1] Department of Obstetrics and Gynecology, University of California, Los Angeles, USA;Medled Medical Missions, Burlingame, California, USA;Faculty of Medicine, Mbarara University of Science and Technology, P.O. BOX 1410, Mbarara, Uganda;Department of Obstetrics and Gynecology, Mbarara Regional Referral Hospital, P.O. BOX 40, Mbarara, Uganda;United Nation Fund for Population Activities, Kampala, Uganda;

关键词: Vaginal agenesis;    Mayer-Rokitansky-Küster-Hauser syndrome;    Skin grafts;    Neovagina;    Vaginal molds;    Case reports;   

DOI  :  10.1186/s12894-017-0258-7

 received in 2016-07-25, accepted in 2017-08-21,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAlthough vaginal agenesis as may occur in Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a rare condition, it is associated with not only anatomical problems but also serious psychological and social problems like painful sexual intercourse, primary amenorrhea and infertility. Surgery, which is aimed at reconstruction of a vagina of adequate length and width to serve the function, is the main method of treatment. Many methods for vaginal reconstruction have been described but each has its complications and limitations. The most commonly preferred procedure for treating this condition is the McIndoe vaginoplasty which involves dissection into the recto-vesical space, inserting two split thickness skin grafts folded over a mold in this newly created space and regular dilatation of the neovagina postoperatively to avoid stenosis. However surgeons with this expertise in this part of the world are rare to find and where they are available, the special molds on which to fold the skin grafts into the neovaginal space are not readily available.Case presentationA 21-year-old female with vaginal agenesis was operated on using a modification of the McIndoe procedure using a cylinder of a 60cm3 syringe as a vaginal mold/form and kept in place. We left a Foley in place for 10 days and we did a dye test after removing the syringe to ensure that there was no leakage resulting from fistula formation.ConclusionThe operation was successful and on subsequent monthly reviews of the patient, she has a patent functional vagina of about 9 cm in length at 8 months after the operation with resumption of sexual intercourse.

【 授权许可】

CC BY   
© The Author(s). 2017