Comparison of Two Techniques of Laparoscopy-Assisted Peritoneal Vaginoplasty

J Minim Invasive Gynecol. 2016 Mar-Apr;23(3):346-51. doi: 10.1016/j.jmig.2015.10.015. Epub 2015 Nov 3.

Abstract

Neovagina creation is essential for patients with the Mayer-Rokitansky-Kuster-Hauser syndrome. We compared a technique involved the pushing down of the peritoneum with the technique of separating the peritoneum for laparoscopy-assisted peritoneal vaginoplasty. We collected patients with congenital absence of vagina who underwent laparoscopy-assisted peritoneal vaginoplasty of the First Affiliated Hospital of Zhengzhou University between January 2011 and May 2013. The 2 surgical groups (pushing group and separating group) were compared for various parameters. The values of the following parameters were significantly lower for the pushing group compared with the separating group: mean operating time (78 ± 13 minutes vs 135 ± 28 minutes), mean duration of hospitalization (12.9 ± 2.7 days vs 18.0 ± 3.8 days), mean cost of hospitalization (14 016 ± 1640 RMB vs 18 783 ± 2143 RMB), requirement for a drainage tube (4% vs 27%; χ(2) = 8.864), requirement for analgesic drugs (20% vs 40%; χ(2) = 3.977), and postoperative rehospitalization (3.3% vs 10.0% at 2 months and 6.7% vs 26.7% at 6 months; χ(2) = 4.268 and 5.196). Mean values for blood loss (57 ± 19 mL vs 66 ± 20 mL), time to pass gas (21 ± 4 hours vs 23 ± 7 hours), and length of the reconstructed vagina (9.0 ± 0.4 cm vs 8.9 ± 0.5 cm) were not significantly different between the 2 groups. In addition, mean postoperative Female Sexual Function Index score did not differ significantly between the 2 groups or among the 2 groups and a control group (27.0 ± 4.8 vs 26.7 ± 5.2 vs 27.9 ± 4.5; p > .05). The technique involving pushing down of the peritoneum offers advantages of reduced cost, complications, hospitalization, operative time, and pain over the traditional technique. Sexuality approaches so-called "normal" sexuality.

Keywords: Laparoscopic vaginoplasty; Peritoneum; Surgery; Vaginal agenesis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 46, XX Disorders of Sex Development / surgery*
  • Adolescent
  • Adult
  • Congenital Abnormalities / surgery*
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Laparoscopy* / methods
  • Mullerian Ducts / abnormalities*
  • Mullerian Ducts / surgery
  • Operative Time
  • Ovarian Diseases / congenital
  • Ovarian Diseases / surgery*
  • Peritoneum / abnormalities
  • Peritoneum / surgery*
  • Plastic Surgery Procedures / methods*
  • Treatment Outcome
  • Vagina / abnormalities
  • Vagina / surgery*

Supplementary concepts

  • Mullerian aplasia