# Novel Vaginoplasty Technique for Management of Vaginal Agenesis and Uterine Cervix Atresia: A Case Report

## TL;DR

A new vaginoplasty technique using the Yang-Monti method is presented for treating vaginal agenesis and cervical atresia in adolescents with small pelvises.

## Contribution

A novel vaginoplasty technique using the Yang-Monti tube principle with end-to-end anastomosis is introduced for pediatric patients.

## Key findings

- The technique successfully created a vaginal canal in a 12-year-old with MRKH syndrome and cervical atresia.
- The patient had no complications four years post-surgery, including no infection or dysmenorrhea.
- The method is suitable for adolescents with small pelvic cavities and avoids ischemic complications.

## Abstract

Various methods for vaginoplasty exist, but the choice depends on anatomy and body size. Conventional vaginoplasty, when performed with bowel segments rather than prosthetic materials, allows modification of canal length but lacks precise control of diameter, rendering it less suitable for pediatric patients and for those with small pelvic cavities. Moreover, the positional traction sometimes necessary under these conditions may compromise mesenteric perfusion and heighten the risk of ischemic complications. This report introduces a novel technique using the Yang-Monti tube principle with end-to-end anastomosis. A 12-year-old girl with type II Mayer-Rokitansky-Küster-Haüser syndrome (MRKH), left hydronephrosis, and hematometra was admitted with abdominal pain. Emergency drainage resolved her symptoms, and imaging revealed a unicornuate uterus, cervical atresia, and vaginal agenesis. A 7 cm sigmoid colon segment was used to create a vaginal canal, connecting the cervix and vaginal vestibular mucosa using the Yang-Monti method. The postoperative course was uneventful; the stent drain was removed after two weeks, and she was discharged on the 23rd day after learning self-care with a Nelaton catheter. Four years post-surgery, she remains healthy, with no complications such as infection or dysmenorrhea. This approach is a useful option for vaginal agenesis with cervical atresia in adolescents with a small pelvis.