Laparoscopically assisted biomaterial graft for reconstruction in congenital atresia of vagina and cervix

Capsule:
A combined laparoscopic and vaginal procedure with biomaterial graft couldbe an effective alternative in selected women with atresia of cervix and vagina.

Authors:
MengHui Li, M.D., Ph.D., ZhenYu Zhang, M.D., Ph.D.

Volume 100, Issue 6, Pages 1784-1787, December 2013

Abstract:

Objective:
To report successful treatment by laparoscopically assisted biomaterial graft for reconstruction in patients with congenital atresia of the uterine cervix and vagina.

Design:
Technique and instrumentations.

Setting:
University-based tertiary care hospital.

Patient(s):
An 18-year-old woman with vaginal agenesis and cervical dysgenesis and a 13-year-old woman with vaginal agenesis and cervical agenesis, both patients with a functional uterus.

Intervention(s):
Creation of a neovagina by vaginal procedure and laparoscopically assisted biomaterial graft for uterovaginal anastomosis was performed in all patients.

Main Outcome Measure(s):
All surgical findings were carefully reviewed to determine the anatomic characteristics of the malformed cervix. Subsequent follow-up was done by referring physicians.

Result(s):
Uterovaginal continuity was established successfully in both patients, and all of the women were menstruating normally. Granulomatous polyps occurred in one patient, and this condition was successfully managed. At 6-month follow-up, mean vaginal length was 12 cm and ≥80% of neovaginal epithelium was iodine positive in both patients. Unimpeded menstrual flow continued after 4 years of follow-up in one patient and 5 years of follow-up in the other patient.

Conclusion(s):
A combined laparoscopic and vaginal procedure with biomaterial graft could be an effective alternative in selected women with atresia of cervix and vagina.

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