A modified neo-vagina procedure in a low resource urogynecological unit: a case report of a 21 year old with Mayer-Rokitansky-Küster-Hauser (mrkh) Syndrome operated at Mbarara referral hospital, Southwestern Uganda
Abstract Background Although vaginal agenesis as may occur in Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a rare condition, it is associated with not only anatomical problems but also serious psychological and social problems like painful sexual intercourse, primary amenorrhea and infertility....
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doaj-bdcaf46f406e4048942df98c1fc130b52020-11-25T02:32:04ZengBMCBMC Urology1471-24902017-08-011711610.1186/s12894-017-0258-7A modified neo-vagina procedure in a low resource urogynecological unit: a case report of a 21 year old with Mayer-Rokitansky-Küster-Hauser (mrkh) Syndrome operated at Mbarara referral hospital, Southwestern UgandaMusa Kayondo0Joseph Njagi1Peter Kivuniike Mukasa2Tom Margolis3Faculty of Medicine, Mbarara University of Science and TechnologyFaculty of Medicine, Mbarara University of Science and TechnologyUnited Nation Fund for Population ActivitiesDepartment of Obstetrics and Gynecology, University of CaliforniaAbstract Background Although vaginal agenesis as may occur in Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a rare condition, it is associated with not only anatomical problems but also serious psychological and social problems like painful sexual intercourse, primary amenorrhea and infertility. Surgery, which is aimed at reconstruction of a vagina of adequate length and width to serve the function, is the main method of treatment. Many methods for vaginal reconstruction have been described but each has its complications and limitations. The most commonly preferred procedure for treating this condition is the McIndoe vaginoplasty which involves dissection into the recto-vesical space, inserting two split thickness skin grafts folded over a mold in this newly created space and regular dilatation of the neovagina postoperatively to avoid stenosis. However surgeons with this expertise in this part of the world are rare to find and where they are available, the special molds on which to fold the skin grafts into the neovaginal space are not readily available. Case presentation A 21-year-old female with vaginal agenesis was operated on using a modification of the McIndoe procedure using a cylinder of a 60cm3 syringe as a vaginal mold/form and kept in place. We left a Foley in place for 10 days and we did a dye test after removing the syringe to ensure that there was no leakage resulting from fistula formation. Conclusion The operation was successful and on subsequent monthly reviews of the patient, she has a patent functional vagina of about 9 cm in length at 8 months after the operation with resumption of sexual intercourse.http://link.springer.com/article/10.1186/s12894-017-0258-7Vaginal agenesisMayer-Rokitansky-Küster-Hauser syndromeSkin graftsNeovaginaVaginal moldsCase reports |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Musa Kayondo Joseph Njagi Peter Kivuniike Mukasa Tom Margolis |
spellingShingle |
Musa Kayondo Joseph Njagi Peter Kivuniike Mukasa Tom Margolis A modified neo-vagina procedure in a low resource urogynecological unit: a case report of a 21 year old with Mayer-Rokitansky-Küster-Hauser (mrkh) Syndrome operated at Mbarara referral hospital, Southwestern Uganda BMC Urology Vaginal agenesis Mayer-Rokitansky-Küster-Hauser syndrome Skin grafts Neovagina Vaginal molds Case reports |
author_facet |
Musa Kayondo Joseph Njagi Peter Kivuniike Mukasa Tom Margolis |
author_sort |
Musa Kayondo |
title |
A modified neo-vagina procedure in a low resource urogynecological unit: a case report of a 21 year old with Mayer-Rokitansky-Küster-Hauser (mrkh) Syndrome operated at Mbarara referral hospital, Southwestern Uganda |
title_short |
A modified neo-vagina procedure in a low resource urogynecological unit: a case report of a 21 year old with Mayer-Rokitansky-Küster-Hauser (mrkh) Syndrome operated at Mbarara referral hospital, Southwestern Uganda |
title_full |
A modified neo-vagina procedure in a low resource urogynecological unit: a case report of a 21 year old with Mayer-Rokitansky-Küster-Hauser (mrkh) Syndrome operated at Mbarara referral hospital, Southwestern Uganda |
title_fullStr |
A modified neo-vagina procedure in a low resource urogynecological unit: a case report of a 21 year old with Mayer-Rokitansky-Küster-Hauser (mrkh) Syndrome operated at Mbarara referral hospital, Southwestern Uganda |
title_full_unstemmed |
A modified neo-vagina procedure in a low resource urogynecological unit: a case report of a 21 year old with Mayer-Rokitansky-Küster-Hauser (mrkh) Syndrome operated at Mbarara referral hospital, Southwestern Uganda |
title_sort |
modified neo-vagina procedure in a low resource urogynecological unit: a case report of a 21 year old with mayer-rokitansky-küster-hauser (mrkh) syndrome operated at mbarara referral hospital, southwestern uganda |
publisher |
BMC |
series |
BMC Urology |
issn |
1471-2490 |
publishDate |
2017-08-01 |
description |
Abstract Background Although vaginal agenesis as may occur in Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a rare condition, it is associated with not only anatomical problems but also serious psychological and social problems like painful sexual intercourse, primary amenorrhea and infertility. Surgery, which is aimed at reconstruction of a vagina of adequate length and width to serve the function, is the main method of treatment. Many methods for vaginal reconstruction have been described but each has its complications and limitations. The most commonly preferred procedure for treating this condition is the McIndoe vaginoplasty which involves dissection into the recto-vesical space, inserting two split thickness skin grafts folded over a mold in this newly created space and regular dilatation of the neovagina postoperatively to avoid stenosis. However surgeons with this expertise in this part of the world are rare to find and where they are available, the special molds on which to fold the skin grafts into the neovaginal space are not readily available. Case presentation A 21-year-old female with vaginal agenesis was operated on using a modification of the McIndoe procedure using a cylinder of a 60cm3 syringe as a vaginal mold/form and kept in place. We left a Foley in place for 10 days and we did a dye test after removing the syringe to ensure that there was no leakage resulting from fistula formation. Conclusion The operation was successful and on subsequent monthly reviews of the patient, she has a patent functional vagina of about 9 cm in length at 8 months after the operation with resumption of sexual intercourse. |
topic |
Vaginal agenesis Mayer-Rokitansky-Küster-Hauser syndrome Skin grafts Neovagina Vaginal molds Case reports |
url |
http://link.springer.com/article/10.1186/s12894-017-0258-7 |
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