Functional and anatomic results of amnion vaginoplasty in young women with Mayer-Rokitansky-Kuster-Hauser syndrome

Objective: To evaluate the surgical outcome and the long-term anatomic and functional results in young women with Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKH) undergoing neovaginal creation with amniotic membranes. Design: Evaluation of surgical and functional outcome according to clinical records and validated questionnaires about sexuality (Female Sexual Function Index [FSFI]) over a 1.5-year follow-up period. Setting: University hospital and referral center for pediatric and adolescent gynecology. Patient(s): Seven patients with congenital vaginal aplasia with a mean age of 20.86 +/- 3.56 years (range 17-26 years). Intervention(s): McIndoe procedure modified by the application of human freeze-dried amniotic membranes. Main Outcome Measure(s): Anatomic success was defined by a vaginal length >= 8 cm, and a width allowing the easy introduction of two fingers. FSFI scores were applied to define functional results. Result(s): Mean neovaginal length was 9.3 cm (range 4-12 cm). The mean FSFI score was 30.0 +/- 6.9. Major operative complications occurred in one patient. In six out of seven patients satisfactory anatomic and functional results were achieved. Conclusion(s): The surgical dissection of the vesicorectal space and the application of human amnion over a vaginal mold to create a neovagina results in satisfying anatomic and functional outcome with low perioperative morbidity in MRKH patients. (Fertil Steril (R) 2010; 94: 317-23. (C) 2010 by American Society for Reproductive Medicine.)