Abstract
Aim: to present the technique of neo-vagina formation with the use of pelvic peritoneum for the treatment of women with vaginal agenesis; to review the data focusing on the postoperative functional results; and to analyze its potential advantages and limitations. Brief description of the review data: Laparoscopic- assisted peritoneal colpopoesis has proven to be reliable and effective method of neovagina creation associated with minimal morbidity and excellent functional and anatomical results. It can be successfully used in patients with vaginal agenesis with or without rudimentary uteri and in patients with previously unsuccessful treatments. Our original experience since 1992 involves 324 patients who underwent this surgery. Long-term evaluation in patients operated on between 1995 and 2013 identified an 87.8 % satisfaction rate as compared with 76 % satisfaction rate in the control group and indicated a functional vaginal length of 12.46 ± 1.16 cm with anatomical vaginal length of 10.87 ± 1.0 cm, and a minimal complications rate. Clinical Implication: Multiple successful methods of neovagina creation are currently used. The pearls for minimizing complications and providing maximal results for the surgeon employing a laparoscopic-assisted peritoneal colpopoesis technique are described in this chapter. Open issues for further research: While technical and methodological advancements for neo-vagina formation continue to develop, research that further identifies etiologic factors in the development of vaginal agenesis, studies related to concomitant pathology in the patients, and investigations into the use of cellular technologies for the formation of the cervical canal in women with functional uteri with vaginal and cervical aplasia would be of a significant importance. Special considerations related to endometriosis in women with mullerian anomalies need further investigation as well.
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References
Davydov SN. Colpopoiesis from the peritoneum of the uterorectal space. Obstet Gynecol. 1969;12:55–7.
Kukakov VI, Adamyan LV. Role of endoscopy in the diagnosis and surgical correction of female genital malformations. In: Kulakov VI, Adamyan LV, editors. Endoscopy in gynecology. Moscow: Medicine; 2000. p. 211–26 (rus).
Adamyan LV. Additional international perspectives: colpopoiesis in vaginal and uterine aplasias. In: Nichols D, editor. Gynecologic and obstetric surgery. St. Louis, USA: Mosby; 1993. p. 1167–82.
Adamyan LV. Therapeutic and endoscopic perspectives: colpopoiesis in vaginal and uterine aplasias. In: Nichols D, editor. Gynecologic and obstetric surgery. St. Louis, USA: Mosby; 1999. p. 187–95.
Adamyan LV. Laparoscopic management of vaginal aplasia with or without functional noncommunicating uterus. In: Arregui ME, editor. Principles of laparoscopic surgery: basic and advanced techniques. New York, USA: Springer; 1995. p. 652–71.
Adamyan LV. Laparoscopy in surgical treatment of vaginal aplasia: laparoscopy assisted colpopoiesis and perineal hysterectomy with colpopoiesis. Int J Fertil. 1996;41(1):40–5.
Kulakov VI, Adamyan LV, Minbayev OA. Correction of genital malformations. In: Kulakov VI, Adamyan LV, editors. Operative gynecology- surgical energies. Minbayev Moscow: Medicine; 2000. p. 691–94 (rus).
Adamyan LV, Iarotskaia EL. Endoscopic diagnosis and correction of malformations of female genitalia. In: Pasic RP, Levine RL, editors. A practical manual of laparoscopy. A clinical cook book. Boca Raton, Nashville, USA: Parthenon Publishing; 2002. p. 271–89.
Adamyan LV. Laparoscopic management of vaginal aplasia with or without functional noncommunicating rudimentary uterus. In: Arrequi ME, Fitzgibbons RJ, Katkhouda N, McKernan JB, Reich H, editors. Principles of laparoscopic surgery. New York: Springer; 1995. p. 646.
Adamyan LV, Makyan ZN, Uvarova EV, Glybina TM, Kurilo LF, Bobkova MV, Stepanian AA. Malformations of female genitalia: classification and management issues. Proceedings: XII international congress with endoscopic course: “New technologies for diagnosis and treatment of gynecologic disease.” Moscow; 2009. (rus/engl).
Adamyan LV, Stenyayeva NN, Makiyan ZN. Sexual function of women after surgical correction of the vaginal and uterine aplasia. In: Proceedings of XXVII congress of: Moscow, Russia; June 2014.
Matton G. Reconstruction of the vagina. In: Beks JWF, Lammers W, editors. The Jonxis lectures, vol 4. Amsterdam: Excerpta Medica; 1980. p. 303–26.
Adamyan LV, Iarotskaya EI. Endoscopic diagnosis and correction of malformations of the female genitalia. In: Laparoscopy and hysteroscopy in obstetrics and gynecology. Patory, Moscow; 2002. (rus).
Fedele L, Busacca M, Candiani M, Vignali M. Laparoscopiccreation of a neovagina in Mayer-Rokitansky- Kuster-Hauser syndrome by modification of Vecchietti’s operation. Am J Obstet Gynecol. 1994;171:268–9.
Vecchietti G. Creation of an artificial vagina in Rokitansky-Kuster-Hauser Syndrome. Attual Ostet Ginecol. 1965;11:131–47.
Vecchietti G. The neovagina in the Robitansky-Kuster-Hauser syndrome. Rev Med Suisse Romande. 1979;99(9):593–601.
Fedele L, Bianchi S, Zanconato G, Raffaelli R. Laparoscopic creation of neovagina in patients with Rokitansky syndrome: analysis of 52 cases. Fertil Steril. 2000;74:384.
Borruto F, Camoglio FS, Zampieri N, Fedele L. The laparoscopic Vecchietti technique for vaginal agenesis. Int J Gynaecol Obstet. 2007;98:15.
Brun JL, Belleannee G, Grafeille N, Aslan AF, Brun GH. Long-term results after neovagina creation in Mayer-Rokitanski-Kuster-Hauser syndrome by Vecchietti’s operation. Eur J Obstet Gynecol Reprod Biol. 2002;103:168–72.
Bianchi S, Frontino G, Ciappina N, Restelli E, Fedele L. Creation of a neovagina in Rokitansky syndrome: comparison between two laparoscopic techniques. Fertil Steril. 2011;95:3.
Brucker SY, Gegusch M, Zubke W, Rall K, Gauwerky JF, Wallwierer D. Neovagina, creation in vaginal agenesis: development of a new laparoscopic Vecchietti-based procedure and optimized instruments in a prospective comparative interventional study in 101 patients. Fertil Steril. 2007;90:1940–52.
Lloyd J, Crouch NS, Minto CL, Liao LM, Creigton SM. Female genital appearance: “normality” unfolds. BJOG. 2005;112:643–6.
Matsui H, Seki K, Sekiya S. Prolapse of the neovagina in Mayer- Rokitansky-Kusher-Hauser syndrome: a case report. J Reprod Med. 1999;44:548–50.
Schaffer J, Fabricant C, Carr BR. Vaginal vault prolapse after non-surgical and surgical treatment of Mullerian agenesis. Obstet Gynecol. 2002;99:947–9.
Paraiso MF, Ballard LA, Walters MD, Lee JC, Mitchinson AR. Pelvis support defects and visceral and sexual function in women treated with sacrospinous ligament suspension and pelvic reconstruction. Am J Obstet Gynecol. 1996;175:1423–30.
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Adamyan, L.V., Stepanian, A.A. (2015). Neovagina Creation with the Use of the Pelvic Peritoneum. In: Grimbizis, G., Campo, R., Tarlatzis, B., Gordts, S. (eds) Female Genital Tract Congenital Malformations. Springer, London. https://doi.org/10.1007/978-1-4471-5146-3_19
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