Abstract
Objective
To compare using the acellular porcine small intestinal submucosa (SIS) graft or the Interceed in patients with MRKH syndrome undergoing creation of a neovagina.
Methods
In this retrospective study, patients with MRKH syndrome undergoing creation of a neovagina from 2016 to 2018 were retrospectively investigated. Wharton–Sheares–George neovaginoplasty was performed using the acellular porcine SIS graft or the Interceed.
Results
Overall, 67 patients were included for analysis. The operating time, the estimated blood loss and return of bowel activity were similar between the two groups. However, the total cost in the SIS group was significantly higher than that in the Interceed group due to the cost of the SIS graft. The mean length and width of the neovagina were similar between the two groups. However, the incidence of granulation in vaginal apex was higher in the SIS graft group than that in the Interceed group. There was no statistically significant difference in the total FSFI scores between the two groups who became sexually active postoperatively.
Conclusions
Our results demonstrated that Wharton–Sheares–George method provided the patients to have satisfactory sexual intercourse. The Interceed played a role in the reconstruction of neovagina no less than the SIS graft.
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References
Oppelt P, Renner SP, Kellermann A et al (2006) Clinical aspects of Mayer–Rokitansky–Kuester–Hauser syndrome: recommendations for clinical diagnosis and staging. Hum Reprod 21:792–797
ACOG (2013) Committee opinion: no. 562: müllerian agenesis: diagnosis, management, and treatment. Committee on Adolescent Health Care. Obstet Gynecol 2013(121):1134–1137
Laufer MR (2002) Congenital absence of the vagina: in search of the perfect solution. When, and by what technique, should a vagina be created? Curr Opin Obstet Gynecol 14:441–444
Ding JX, Zhang XY, Chen LM et al (2013) Vaginoplasty using acellular porcine small Intestinal submucosa graft in two patients with Meyer–von-Rokitansky–Küster–Hauser syndrome: a prospective new technique for vaginalre construction. Gynecol Obstet Invest 75:93–96
Schätz T, Huber J, Wenzl R (2005) Creation of a neovagina according to Wharton–Sheares–George in patients with Mayer–Rokitansky–Küster–Hauser syndrome. Fertil Steril 83(2):437–441
Jackson ND, Rosenblatt PL (1994) Use of Interceed absorbable adhesion barrier for vaginoplasty. Obstet Gynecol 84:1048–1050
Basonbul RA, Cohen MS (2017) Use of porcine small intestinal submucosa for pediatric endoscopic tympanic membrane repair. World J Otorhinolaryngol Head Neck Surg 3:142–147
D’Eredità R (2015) Porcine small intestinal submucosa (SIS) myringoplasty in children: a randomized controlled study. Int J Pediatr Otorhinolaryngol 79:1085–1089
Ding JX, Chen XJ, Zhang XY et al (2014) Acellular porcine small intestinal submucosa graft or cervicovaginal reconstruction in eight patients with malformation of the uterine cervix. Hum Reprod 29:677–682
Ding JX, Chen LM, Zhang XY et al (2015) Sexual and functional outcomes of vaginoplasty using acellular porcine small intestinalsubmucosa graft or laparoscopic peritoneal vaginoplasty: a comparative study. Hum Reprod 30:581–589
Shen F, Zhang XY, Yin CY et al (2016) Comparison of small intestinal submucosa graft with split-thickness skin graft for cervico vaginal reconstruction of congenital vaginal and cervical aplasia. Hum Reprod 31:2499–2505
Walch K, Kowarik E, Leithner K et al (2011) Functional and anatomic results after creation of a neovagina according to Wharton–Sheares–George in patients with Mayer–Rokitansky–Küster–Hauser syndrome-long-term follow-up. Fertil Steril 96:492–497
Ahmad G, O’Flynn H, Hindocha A et al (2015) Barrier agents for adhesion prevention after gynaecological surgery. Cochrane Database Syst Rev 30:CD000475
Metwally M, Cheong Y, Li TC (2008) Areview of techniques for adhesion prevention after gynaecological surgery. Curr Opin Obstet Gynecol 20:345–352
Lee J, Bae Y (2014) The use of absorbable interceed(®) pouch with double-layer skin closure for partial defect of breast. Breast J 20:414–419
Motoyama S, Laoag-Fernandez JB, Mochizuki S et al (2003) Vaginoplasty with Interceed absorbable adhesion barrier for complete squamous epithelialization in vaginal agenesis. Am J Obstet Gynecol 188:1260–1264
Inagaki M, Motoyama S, Laoag-Fernandez JB et al (2009) Two case reports of less invasive surgery using interceed (oxidized regenerated cellulose) absorbable adhesion barrier for vaginoplasty in Meyer–Rokitansky–Küster–Hauser syndrome. Int Surg 94:48–53
Zhang X, Ding Y, Hua K et al (2019) Combined laparoscopic and vaginal cervicovaginal reconstruction using acellular porcine small intestinal submucosa graft in a patient with Mayer–Rokitansky–Küster–Hauser syndrome(U5aC4V4). J Minim Invasive Gynecol 26:396–397
Acknowledgements
This study was supported by a grant from the Science and Technology Commission of Shanghai Municipality (Grant No. 17411960900).
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KH, JD contributed to the design of the manuscript. XZ, JD helped in writing the manuscript. JQ contributed to the statistics.
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Zhang, X., Qiu, J., Ding, J. et al. Comparison of neovaginoplasty using acellular porcine small intestinal submucosa graft or Interceed in patients with Mayer–Rokitansky–Küster–Hauser syndrome. Arch Gynecol Obstet 300, 1633–1636 (2019). https://doi.org/10.1007/s00404-019-05352-0
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DOI: https://doi.org/10.1007/s00404-019-05352-0