Intestinal vaginoplasty: seven years' experience of a tertiary center.

OBJECTIVE: To investigate the long-term effects of intestinal vaginoplasty in cases with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome.

DESIGN: Prospective study.

SETTING: Division of Pelvic Reconstructive Surgery, Department of Gynecology and Obstetrics, at a women's and children disease education and research hospital.

PATIENT(S): Between 2003 and 2009, 29 patients with MRKH syndrome underwent intestinal vaginoplasty.

INTERVENTION(S): Two of the patients were treated with ileal and 27 with sigmoid vaginoplasty.

MAIN OUTCOME MEASURE(S): The age, marital status, associated anomalies, method used for bowel transposition (isoperistaltic/antiperistaltic), type of abdominal incision, and intra- and postoperative complications were evaluated.

RESULT(S): One of the patients for whom ileal vaginoplasty was performed had 40 cm ileal necrosis requiring bilateral ileostomy for 2 months. Introital stenosis was detected in 15 cases (79%) who were unmarried, while none of the married cases had introital stenosis. However, all patients responded to finger-dilatation. All married patients were sexually satisfied after operation. An intraluminal abscess developed in the proximal segment of the neovagina owing to stricture occurring above abdominoperineal tunnel 2 years after operation. In another patient who had a rudimentary uterine horn, hematometra developed 3 years after operation and treated with resection.

CONCLUSION(S): In our experience, sigmoid vaginoplasty seems to be a favorable procedure which provides excellent long-term results for the patients with vaginal agenesis.