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Comparison of two laparoscopic vaginoplasties using a single peritoneal flap in patients with Mayer-Rokitansky-Küster-Hauser syndrome

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Abstract

Introduction and hypothesis

To compare two laparoscopic vaginoplasties using a single peritoneal flap (SPF), namely the Hebei I technique and the Hebei II technique, for creation of a neovagina in patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome.

Methods

A comparative retrospective study was conducted at a university-based tertiary care hospital. From September 2008 to September 2019, 72 patients with MRKH syndrome underwent either the Hebei I technique (n = 49) or the Hebei II technique (n = 23). The perioperative results, complications and anatomical outcomes of two groups were recorded and compared. The functional results of patients who became sexually active were assessed through the Female Sexual Function Index (FSFI) questionnaire.

Results

Two techniques achieved anatomical and functional success without intraoperative complications. There was no significant difference in perioperative results, anatomical findings and the FSFI scores between the two groups. Patients in the Hebei II group had a relatively shorter operative time than those in the Hebei I group (P = 0.064). What is more, compared with the Hebei I group, the Hebei II group had significantly fewer granulomatous polyps at the top of the neovagina (P = 0.029) and less mucous production of the neovagina (P = 0.025) during the first 3 months after surgery.

Conclusions

Both the Hebei I and Hebei II techniques are feasible approaches for creating a neovagina which can bring satisfactory anatomical and sexual outcomes in patients with MRKH syndrome. However, the Hebei II technique may be a good alternative to the Hebei I technique because of its relatively shorter operative time, fewer neovaginal secretions and fewer granulomatous polyps.

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Acknowledgements

We acknowledge Hui Zhang, Jun Zhang and Shucheng Chen in the Department of Obstetrics and Gynaecology, the Fourth Hospital of Hebei Medical University, China, for their assistance in recruiting study subjects and recording study data.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Fourth Hospital of Hebei Medical University, 12 Jiankang Road, Shijiazhuang, 050011, People’s Republic of China

    Xiwa Zhao, Yanan Zhang, Mengmeng Zhang, Haibo Zhang, Yunjie Tian & Shan Kang

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  1. Xiwa Zhao
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  2. Yanan Zhang
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  3. Mengmeng Zhang
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  4. Haibo Zhang
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  5. Yunjie Tian
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  6. Shan Kang
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Correspondence to Shan Kang.

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Zhao, X., Zhang, Y., Zhang, M. et al. Comparison of two laparoscopic vaginoplasties using a single peritoneal flap in patients with Mayer-Rokitansky-Küster-Hauser syndrome. Int Urogynecol J 33, 2543–2549 (2022). https://doi.org/10.1007/s00192-021-04921-9

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  • DOI: https://doi.org/10.1007/s00192-021-04921-9

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