Publication:

Vaginoplasty in mayer Rokitansky-Kuster-Hauser syndrome using amnion: a case series

Background Congenital absence of both uterus and vagina is termed Mullerian aplasia, Mullerian agenesis, or Mayer-Rokitansky-Kuster-Hauser syndrome. In classical mullerian agenesis patients have a shallow vaginal pouch, only measuring 1 to 2 inches deep. In addition the uterus, cervix, and upper part of the vagina are absent. One treatment goal for most of these women is creation of an artificial vagina either conservatively or surgically. McIndoe procedure is the most commonly employed surgical approach for creation of neovagina. The neovagina thus created is lined with skin graft, amniotic membrane, cutaneous and myocutaneous flaps, buccal mucosa, and absorbable adhesion barrier.

Methods This study was conducted on 8 patients presenting with MRKH syndrome over a period of 3 years from 2012-2015. All the patients were admitted in SVBP hospital associated to LLRM Medical College, Meerut, (UP). McIndoe procedure was the surgical treatment common to all patients, where the neovagina created was lined by amniotic membrane. The surgery was performed by two consultants using the standardized surgical technique.

Results In our study, all patients were followed for preferably 6 months (1,4,8,12 weeks and if possible 6 months) after surgery for following observations-vaginal caliber, presence of any stricture, vaginal sloughing, failure of graft uptake any urogenital complaints. Except for complication in one patient, all the rest had excellent results.

Conclusions Vaginoplasty using amnion as a graft is a safe, effective treatment in patients of MRKH Syndrome. When done by experienced gynecologist, major post operative complications seem to be very few.