A new era for treating vaginal aplasia using transretropubic balloon vaginoplasty approach.

OBJECTIVE

To test the efficacy, safety, and tolerability of a novel surgical alternative for formation of a neovagina in patients with vaginal aplasia.

DESIGN

Technique and instrumentations.

SETTING

A specialized endoscopic surgery center.

PATIENT(S): Four patients with complete vaginal aplasia, three of them without a uterus and one with a functioning uterus.

INTERVENTION(S): A silicone Foley catheter sutured to the distal end of a sharp curved needle with a wide eye attached to a plastic handle and passed extraperitoneally into the space of Retzius followed by its inflation and upward traction for 8 days. Clinical and magnetic resonance imaging (MRI) follow-up were done.

MAIN OUTCOME MEASURE(S): Operative time, complication rate, tolerability of traction and retraction, reintervention rate, width and length of the newly formed vagina, and postoperative feasibility of intravaginal sexual intercourse for married cases.

RESULT(S): The results were satisfactory (normal length and width of neovagina), without complications and with acceptable tolerability and normal sexual life within 8-10 days postoperatively for the married women.

CONCLUSION(S): Both clinical and MRI follow-up confirmed that retropubic balloon vaginoplasty is a simple, fast, tolerable, safe, and available extraperitoneal procedure. It can be easily done by any gynecologist having basic knowledge of the anatomy of the retropubic space.