A New Ten-Step Surgical Approach to Mayer–Rokitansky–Küster–Hauser Syndrome—A Preliminary Report of Three Cases

TL;DR

A new 10-step surgical method for MRKH syndrome is described, showing effective and lasting results in three patients.

Contribution

A novel surgical approach combining laparoscopic and perineal techniques for vaginal reconstruction in MRKH syndrome is introduced.

Findings

The neovagina had an average length of 11.33 cm with no stenosis or granulation tissue after 5 years.

All patients reported satisfactory sexual activity and improved quality of life.

Two patients resolved their marital issues following the procedure.

Abstract

Background: Vaginal reconstruction procedures for patients with Mayer–Rokitansky–Küster–Hauser syndrome (MRKH) have the main purpose of restoring the anatomy to increase the quality of life of these patients. To describe the surgical treatment of patients with type I Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome with complete vaginal agenesis in 10 steps, using a sacropexy technique by a double approach (laparoscopic and perineal), which could help make this procedure more accessible and safer. Methods: The surgical technique was used in a group of three patients diagnosed with MRKH syndrome with vaginal agenesis, in which a neovagina with peritoneal flaps was created, and the reconstruction of the vaginal apex and its sacropexy created the conditions for a favorable and lasting result. Results: Annual reevaluations for up to 5 years revealed a functional neovagina with an average length of approximately 11.33 cm, without stenotic aspects, and no granulation tissue formation. All three cases in which this technique was performed reported sexual activity as expected, excellent quality of life, and good psycho-emotional reintegration. It should be noted that two of the three patients also resolved their marital situation. Conclusions: Although the number of patients in this preliminary report is limited, the surgical technique presented is an effective, safe approach with very good anatomical and functional results at the 5-year follow-up. The favorable surgical outcome of these cases also determined the social integration of the patients, solving some ethnic and religious problems.

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