Laparoscopic Peritoneal Vaginoplasty for Mayer-Rokitansky-Kuster-Hauser Syndrome: An Experience at a Tertiary Care Center

Objective: Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a congenital aplasia or severe hypoplasia of derivatives of the Mullerian ducts. Various methods of neovaginal creation have been described in the literature, each with its own advantages and disadvantages. This article presents the authors' experience with laparoscopic Davydov's peritoneal pull-through vaginoplasty in a tertiary-care center. Materials and Methods: This is a clinical case series of 13 women with MRKH syndrome who underwent laparoscopic Davydov's vaginoplasty in a tertiary-care center from January 2012 to May 2016. The procedure was planned 3 months before marriage. The procedure, intraoperative and postoperative details, and follow-ups of the women are presented. Results: Preoperative vaginal length, operating time, and blood loss were 1.38 +/- 0.96cm, 98.61 +/- 6.18 minutes, and 33.07 +/- 10.31mL, respectively. There were no conversions to laparotomy; no blood transfusions; and no bladder, ureter, or bowel injuries. Postoperative vaginal length at 6 months was 8.23 +/- 1.16cm. Intercourse was attempted after 97.41 +/- 21.84 days postsurgery. All patients had regular follow-ups at 6 weeks, 3 months, and 6 months, and 10 patients reported sexual satisfaction by both partners. Two patients with overall vaginal stenosis and 1 patient with apical stenosis were managed by lateral releasing incisions and a wider mold, respectively. Conclusions: Laparoscopic Davydov's procedure is a safe and effective approach for creating neovaginas in women with MRKH syndrome. The procedure has various advantages and confers lowered morbidity on patients.