Creation of a neovagina in Rokitansky syndrome: comparison between two laparoscopic techniques

Fertil Steril. 2011 Mar 1;95(3):1098-100.e1-3. doi: 10.1016/j.fertnstert.2010.11.032. Epub 2010 Dec 17.

Abstract

Objective: To compare Vecchietti's and Davydov's laparoscopic techniques for creation of a neovagina in patients with Rokitansky syndrome.

Design: Comparative retrospective study.

Setting: Tertiary referral center for the treatment of Rokitansky syndrome.

Patient(s): Eighty patients with Rokitansky syndrome.

Intervention(s): Patients underwent surgical creation of a neovagina. Fifteen patients who underwent the Vecchietti procedure from October 2003 to December 2004 and 30 patients who underwent the Davydov procedure from June 2005 to August 2008 were also included from two previously published studies. Follow-up lasted at least 12 months.

Main outcome measure(s): Intraoperative parameters and anatomic results were compared. Functional results were compared through the Female Sexual Function Index. Epithelization of the neovagina was assessed in both groups through vaginoscopy and Schiller's test.

Result(s): No major intraoperative complications were encountered in either group. Mean (±SD) duration of surgery was 30 ± 9.6 and 134 ± 24 minutes in Vecchietti's and Davydov's approach, respectively. At 12 postoperative months, length and width of the neovagina in the two groups were 7.5 ± 1.1 and 2.8 ± 0.6 cm, and 8.5 ± 1.6 and 2.8 ± 0.65, respectively. Epithelization of the neovagina at 6-month follow-up was 60% and 80%, respectively, and 100% in both groups at 12 postoperative months.

Conclusion(s): Anatomic and functional outcomes of the two approaches tend to be comparable at 12-month follow-up; the only significant difference seems to be in greater length for the neovagina obtained by Davydov's approach.

Publication types

  • Comparative Study

MeSH terms

  • 46, XX Disorders of Sex Development / surgery
  • Abnormalities, Multiple / surgery
  • Adolescent
  • Congenital Abnormalities
  • Female
  • Follow-Up Studies
  • Gynecologic Surgical Procedures / methods*
  • Humans
  • Kidney / abnormalities
  • Laparoscopy / methods*
  • Mullerian Ducts / abnormalities
  • Postoperative Complications
  • Retrospective Studies
  • Sexuality
  • Somites / abnormalities
  • Spine / abnormalities
  • Uterus / abnormalities
  • Uterus / surgery
  • Vagina / abnormalities*
  • Vagina / surgery*
  • Young Adult

Supplementary concepts

  • Mullerian aplasia