Surgical treatment

         There are a number of surgical techniques which help to create a new vagina and the majority of them are very invasive. The most common ways of surgery are the following:

McIndoe Vaginoplasty

        It is a very difficult procedure which needs the transplants from the leg or a thigh to make the implant in the vagina for the period up to 3 months after surgical operation. But even after it, vaginal dilators should be used for some time.

Vecchietti Procedure
          The procedure applies an acrylic olive shape device that is put under tension against the dimple in the vagina. The device stretches the abdominal wall and with time puts the olive upward stretching the skin, thus creating neovagina. The procedure can take up to 3 months with the dilators used after it. Vecchietti procedure helps to create a vagina which is very close to the normal one. This operation is not so long and takes only 45 minutes.

Bowel Vaginoplasty
         The sigmoid colon or other tag of intestinal bowel may be put into the pelvis and applied for creation of a new vagina. It is an elaborate abdominal surgery with the resection of the bowels which has its risks and complications.

Davydov Procedure
        It is a very complicated operation which requires the transplant from the leg or a thigh which are put, as an implant into the vagina approximately for 3 months. After it the use of dilators is recommended.

Uterine transplantation
         It is another approach of treating the syndrome. A number of women experienced such a procedure but still it is considered to be an experimental one. It was even registered that the operation resulted in the number of pregnancies in some patients but all they had miscarriages.

Laparoscopic procedure
        Also, one may have autotransplant of a resected sigmoid colon with the help of laparoscopy. The results of the surgery report to be very good. It is the modified Davydov procedure with the elements of laparoscopy. Such a new approach makes the operation less invasive. The procedure is conducted through little incisions in the abdomen and belly button. The recent study has shown high success rates of the operation. As a rule, patients can have normal sexual activity after it. The operation gives better results in comparison with other surgical operations and lead to little risks of scarring tissue. The procedure takes from 1 up to 2 hours. The recovery period is usually quick and approximately takes 2 weeks. A doctor leaves the vaginal pack only for 36-48 hours, compared to other procedures when this pack is put almost for 1-2 months. The pain is not so strong, that’s why a patient can return to her everyday activities very rapidly. The risks of such a procedure are very little. The approximate success rates reach 90 % when a patient has a complete functional vagina and normal sexual intercourse. The current studies and research promise that with time laboratory structures will be used to lessen the complications of the vaginal area and they will be created with the help of a woman’s own cells. Of course, surgery is only one step toward the treatment of MRKH in girls. One should have an appropriate counseling with the doctor before doing the surgery. The patient and her family should be ready mentally to go through such a procedure.


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