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Abstract
Objective: The primary goal of treatment in patient with vaginal agenesis is create a new vagina which has physiological functions and abilities to normal sexual intercourse. We report a simple and safe neovaginoplasty procedure using peritoneal flap in our institution.
Methods: Two patients with vaginal agenesisunderwent neovaginal procedure by using peritoneal flap between bladder and rectum. Patients were placed at lithotomy position and laparoscopy was performed with standard surgical laparoscopic equipment. Under video monitoring, abnormalities of genital tract were inspected and proximity of the lower end of pelvic peritoneum to the introitus was assessed by simultaneous digital rectal examination. A transversal line was incised on the vaginal dimple and the recto - vesical space was bluntly dissected creating a new vaginal canal. Once the top of new vaginal was opened into pelvic cavity, incised peritoneum flaps were pulled down to vaginal epithelium. Cystoscopy and digital rectal examination were done to investigate the injury of bladder and rectum. A sterile latex covered gauze sponge was placed at neovaginal for dilation and drainage.
Results: The mean operative time was 120 minutes, mean estimated blood loss was 50mL, mean hospital stay was 5 days. No severe complication was observed, urethral catheter was removed after 3 days, patients were discharged after 5 - 7 days. Two months after surgery, neovaginal was pink, moist and 11 cm deep and more than two finger breathes wide. Sexual intercourse was successful after 3 months.
Conclusion: Our initial results show that neovaginoplasty procedure using peritoneal flap is a simple, safe and minimally invasive technique creating a new vaginal canal with sufficient dimensions and sexual functions.
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| Published | 01-01-2025 | |
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| Issue | No. 81 (2022) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.81.3 | |
| Keywords | Tạo hình âm đạo, vạt phúc mạc, bất sản âm đạo Neovaginoplasty, vaginal reconstruction, peritoneal flap, Davydov’s procedure |
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