Opening the Anterior Vaginal Vault: A Novel Approach to Vaginoplasty with a Modified McIndoe Procedure Using an Artificial Dermis - 24/09/14

Doi : 10.1016/j.jpag.2014.02.016

Yasuhiko Kamada, MD, PhD ^1,^⁎ , Ai Sakamoto, MD ^1,², Kazuhiro Tabuchi, MD ^1,², Miwa Matsuda, MD ^1,², Keiko Shimizu, MD ^1,², Mikiya Nakatsuka, MD, PhD ^1,³, Yuji Hiramatsu, MD, PhD ^1,²
¹ Department of Obstetrics and Gynecology, Okayama University Hospital, Okayama, Japan
² Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
³ Graduate School of Health Sciences, Okayama University, Okayama, Japan

^∗Address correspondence to: Yasuhiko Kamada, MD, PhD, Department of Obstetrics and Gynecology, Okayama University Medical School, 2-5-1 Shikata, Kita-ku, Okayama-city, Okayama 700-8558, Japan; fax: +81-86-225-9570

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Wednesday 24 September 2014

Abstract

Background

Although preparation of a potential vaginal space between the bladder and rectum is a pivotal step in various vaginal reconstructions for patients with vaginal agenesis, few papers have mentioned the importance of this procedure.

Case

We report the successful creation of a neovagina in 3 Japanese patients with Mayer-Rokitansky-Küster-Hauser syndrome using a novel modified McIndoe procedure that involved separation between the bladder and the rudimentary uterus in a laparoscopically assisted manner.

Summary and Conclusion

Opening “the anterior vaginal vault” between the bladder and uterus is a novel concept of vaginal reconstruction; this approach has not been described hitherto in the literature. Based on the outcome of our cases, we conclude that this procedure is advantageous in creating a large and soft neovagina.

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Key Words : Anterior vaginal vault, Artificial dermis, Neovagina, Potential vaginal space, Vaginal agenesis, Vaginal canal, Vaginoplasty