Laparoscopically Assisted Uterovaginal Canalization and Vaginoplasty for Patients with Congenital Cervical and Vaginal Atresia: A Step-by-step Guide and Long-term Outcomes.

STUDY

OBJECTIVE

To study the long-term outcomes of laparoscopically assisted uterovaginal canalization and vaginoplasty in patients with congenital cervical and vaginal atresia and to introduce the surgery step by step.

DESIGN

A prospective observational study from January 2016 to September 2019.

SETTING

A tertiary teaching hospital.

PATIENTS: Ten women diagnosed with congenital cervical and vaginal atresia.

INTERVENTIONS: All women underwent laparoscopically assisted uterovaginal canalization and vaginoplasty.

MEASUREMENTS AND MAIN

RESULTS

All procedures went smoothly, with no case requiring conversion to laparotomy, and no intraoperative complications occurred. Postoperative febrile morbidity occurred in 1 patient (1/10, 10%). The median (interquartile range) follow-up time was 26.0 (21.3, 48.3) months. All patients resumed menstruation, including 9 patients (9/10, 90%) with regular monthly menstruation. Eight patients (8/10, 80%) experienced mild to moderate dysmenorrhea; the remaining 2 patients (2/10, 20%) had no dysmenorrhea. Cervical restenosis occurred in 1 patient (1/10, 10%) 12 months postoperatively, and cervical dilation was performed. So far, 8 months after the second surgery, no restenosis has been found. The mean postoperative vaginal length was 7.9 ± 1.3-cm at the time of the last follow-up. Only 1 patient attempted to conceive for 2 years, but she had not conceived yet.

CONCLUSION

Laparoscopically assisted uterovaginal canalization and vaginoplasty is an easy, safe, and promising management option for correcting congenital cervical and vaginal atresia.