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Vaginoplasty: modified McIndoe using xenograft and a tailored 3D-printer mold

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Abstract

Introduction and hypothesis

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is the congenital absence of the vagina with variable uterine development. Different methods have been reported for vaginoplasty treatment. The preferred vaginal approach to treating this condition is usually McIndoe vaginoplasty supported by regular dilatation of the neovagina. We present a case video of a McIndoe modified vaginoplasty technique with a heterologous graft using a covering customized 3D-printed mold, its postoperative follow-up and postoperative complications.

Methods

Video presentation of a McIndoe modified vaginoplasty technique using porcine intestinal submucosa performed in a 18-year-old woman diagnosed with MRKH syndrome. Different sizes of a polylactic acid mold were manufactured with 3D printers. After dissection of the recto-vesical space, a mold tailored in terms of length and width was chosen for this patient.

Results

After 13 days of follow-up, the patient presented graft infection and subsequent total graft detachment. However, the patient continued to use the vaginal dilator permanently. After 7 months, 8 cm vaginal length with 90% epithelialization and satisfactory sexual intercourse were achieved.

Conclusion

Functional, histological and anatomical results were reached despite the graft detachment. New technologies such as 3D printing facilitate the development of techniques using tailored molds.

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References

  1. Herlin M, Bjørn A-MB, Rasmussen M, Trolle B, Petersen MB. Prevalence and patient characteristics of Mayer-Rokitansky-Küster-Hauser syndrome: a nationwide registry-based study. Hum Reprod. 2016;31:2384–90. https://doi.org/10.1093/humrep/dew220.

    Article  PubMed  Google Scholar 

  2. Anagani M, Agrawal P, Meka K, Narayana RT, Bandameedipally R. Novel minimally invasive technique of neovaginoplasty using an absorbable adhesion barrier. J Minim Invasive Gynecol. 2020 Jan;27(1):206–11.

    Article  Google Scholar 

  3. Zhang X, Liu Z, Yang Y, Yao Y, Tao Y. The clinical outcomes of vaginoplasty using tissue-engineered biomaterial mesh in patients with Mayer-Rokitansky-Küster-Hauser syndrome. Int J Surg. 2017 Aug;44:9–14.

    Article  Google Scholar 

  4. Edmonds DK. Congenital malformations of the genital tract and their management. Best Pract Res Clin Obstet Gynaecol. 2003 Feb;17(1):19–40.

    Article  Google Scholar 

  5. McQuillan SK, Grover SR. Dilation and surgical management in vaginal agenesis: a systematic review. Int Urogynecol J. 2014 Mar;25(3):299–311.

    Article  Google Scholar 

  6. McIndoe AH, Bright BJ. An operation for the cure of congenital absence of the vagina. BJOG: An International Journal of Obstetrics and Gynaecology. 1938;45:490–4. https://doi.org/10.1111/j.1471-0528.1938.tb11141.x.

    Article  Google Scholar 

  7. Acién P, Acién M, Oliva-Meyer M-A, Sánchez-Lozano M, Martínez-Garcia J. McIndoe operation without skin graft: a new neovaginal prosthesis of polylactic acid (PLA). British Journal of Medicine and Medical Research. 2016;18:1–7. https://doi.org/10.9734/bjmmr/2016/29512.

    Article  Google Scholar 

  8. Teng Y, Zhu L, Chong Y, Zeng A, Liu Z, Yu N, et al. The modified McIndoe technique: a scar-free surgical approach for vaginoplasty with an autologous micromucosa graft. Urology. 2019 Sep;131:240–4.

    Article  Google Scholar 

  9. Ding J-X, Zhang X-Y, Chen L-M, Hua K-Q. Vaginoplasty using acellular porcine small intestinal submucosa graft in two patients with Meyer-von-Rokitansky-Küster-Hauser syndrome: a prospective new technique for vaginal reconstruction. Gynecol Obstet Investig. 2013;75(2):93–6.

    Article  Google Scholar 

  10. Wharton LR. A simple method of constructing a vagina: report of four cases. Ann Surg. 1938 May;107(5):842–54.

    Article  CAS  Google Scholar 

  11. Han S-E, Go JY, Choi DS, Seo GH, Lim SY. Experience with specially designed pored polyacetal mold dressing method used in McIndoe-style vaginoplasty. J Pediatr Urol. 2017 Dec;13(6):621.e1–6.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Gynecology, Hospital Italiano de Buenos Aires, Potosí 4135, 1199, Buenos Aires, Argentina

    Lucila I. Pavan, Geronimo A. Bourguignon & Enrique P. Ubertazzi

  2. Urogynecology and Reconstructive Pelvic Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Lucila I. Pavan, Geronimo A. Bourguignon & Enrique P. Ubertazzi

Authors
  1. Lucila I. Pavan
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  2. Geronimo A. Bourguignon
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  3. Enrique P. Ubertazzi
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Corresponding author

Correspondence to Lucila I. Pavan.

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Written informed consent was obtained from the patient for publication of this video article and any accompanying images.

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The authors declare that they have no conflicts of interest and nothing to disclose.

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Approval was obtained from the hospital ethics committee.

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Pavan, L.I., Bourguignon, G.A. & Ubertazzi, E.P. Vaginoplasty: modified McIndoe using xenograft and a tailored 3D-printer mold. Int Urogynecol J 32, 2283–2285 (2021). https://doi.org/10.1007/s00192-021-04689-y

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  • DOI: https://doi.org/10.1007/s00192-021-04689-y

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