Postoperative outcomes of sigmoid colon vaginoplasty for vaginal agenesis: A randomized controlled trial

Ann Med Surg (Lond). 2022 May 20:78:103833. doi: 10.1016/j.amsu.2022.103833. eCollection 2022 Jun.

Abstract

Objective: Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH) is a rare disorder in women that is associated with vaginal agenesis and hypoplasia or loss of uterus. In this study we aim to study the outcome of sigmoid colon vaginoplasty among MRKH patients with vaginal agenesis.

Methods: In this randomized clinical trial study, from 2017 to 2021, 39 patients were reported to our center with vaginal agenesis as a result of MRKH. Patients were treated with sigmoid colon vaginoplasty and postoperative outcomes such as Female sexual function index (FSFI), depth of vaginal cavity, and postoperative complications were evaluated.

Results: The mean age of the patients was 32.3 ± 2.3 years. 18 patients (46.2%) were diagnosed using MRI whereas 21 patients (53.8%) were diagnosed with exploratory laparoscopy. The mean vaginal depth before and after the surgery was 2.8 cm and 17.3 cm, respectively. One patient (2.6%) developed fistula, and peritonitis due to perforation of the vagina, 26 months after surgery, respectively. Of 10 patients who were sexually active after the surgery, all of these patients were sexually satisfied. The FSFI was 32 ± 3.9.

Conclusion: The postoperative complications after sigmoid colon vaginoplasty were minimum and all the sexually active patients were sexually active. This method appears to be an effective for surgical treatment of vaginal agenesis.

Keywords: Hypoplasia; MRKH; Uterus; Vaginal agenesis; Vaginoplasty.