Case Report
Year 2022,
Volume: 7 Issue: 4, 631 - 635, 10.12.2022
Abstract
Meyer Rokitamsky Kuster Hauser sendromlu 21 yaşındaki bir kadın amenore ve koitus sırasında vajinal penetrasyon sağlayamama şikayetleri ile başvurdu. Manyetik rezonans incelemede normal görünen overlerin yanında bilaterak rudimenter uterin kalıntılar ve uterus yokluğu tespit edildi. Laparoskopik olarak vajinal yolla yukarı itilmiş olan pelvik peritona ve vezikorektal boşluktaki vajinal apekse 3 cm'lik bir insizyon yapılarak kör vajinaya 2 parmak genişliğinde bir açıklık oluşturuldu. Ön ve arka viseral periton kenarları vajinal grasper yardımı ile yeni oluşturulmuş vajinal açıklıktan aşağı doğru çekilerek vajinal epitelyal sınıra dikildi. Purse string sütür tekniği ile sütüre edilerek yeni oluşturulmuş olan neovajinal açıklık kapatıldı. Hastanın postoperatif dönemi sorunsuz geçti. Hasta 3 ay boyunca geceleri vajinal silikon dilatatör kullandı ve takiben cinsel aktivitede bulunmasına izin verildi. Modifiye Davydov prosedürü diğer cerrahi yöntemlerle karşılaştırıldığında; düşük komplikasyon oranları ve düşük vajinal stenoz oranlarının yanında daha iyi kozmetik sonuçlar ve daha yüksek seksüel tatmin oranları olan etkili bir cerrahi işlemdir.
Keywords
Supporting Institution
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Project Number
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Thanks
Ankara Şehir Hastanesi Kadın Hastalıkları ve Doğum Hastanesi Ameliyathane Personeline vakanın gerçekleştirilmesi esnasındaki yardımları için teşekkür ederiz.
References
- Davydov SN, Zhvitiascvili OD. Formation of vagina (colpopoiesis) from peritoneum of Douglas pouch. Acta Chir Plast. 1974;16(1):35-41.
- Adamyan LV, Kulakov VI, Murvatov KD, Zurabiani Z. Application of endoscopy in surgery for malformations of genitalia. J Am Assoc Gynecol Laparosc.1994;1(4, Part 2):1. doi:10.1016/s1074-3804(05)80868-0
- Fedele L, Frontino G, Restelli E, Ciappina N, Motta F, Bianchi S. Creation of a neovagina by Davydov's laparoscopic modified technique in patients with Rokitansky syndrome. Am J Obstet Gynecol. 2010;202(1):33.e1-6. doi:10.1016/j.ajog.2009.08.035
- Dargent D, Marchiolè P, Giannesi A, Benchaïb M, Chevret-Méasson M, Mathevet P. Laparoscopic Davydov or laparoscopic transposition of the peritoneal colpopoiesis described by Davydov for the treatment of congenital vaginal genesi: the technique and its evolution. Gynecol Obstet Fertil. 2004;32(12):1023-1030.
- Darai E, Toullalan O, Besse O, Potiron L, Delga P. Anatomic and functional results of laparoscopic-perineal neovagina construction by sigmoid colpoplasty in women with Rokitansky’s syndrome. Hum Reprod. 2003;18(11):2454-2459.
- Giannesi A, Marchiole P, Benchaib M, Chevret-Measson M, Mathevet P, Dargent D. Sexuality after laparoscopic Davydov in patients affected by congenital complete vaginal agenesis associated with uterine agenesis or hypoplasia. Hum Reprod. 2005;20(10):2954-2957.
- Ismail IS, Cutner AS, Creighton SM. Laparoscopic vaginoplasty: Alternative techniques in vaginal reconstruction. BJOG. 2006;113(3):340-343. doi:10.1111/j.1471-0528.2005.00845.x
- Templeman CL, Hertweck SP, Levine RL, Reich H. Use of laparoscopically mobilized peritoneum in the creation of a neovagina. Fertil Steril. 2000;74(3):589-592. doi:10.1016/s0015-0282(00)00700-7.74:589-92
- Rosen R, Brown C, Heiman J, et al. The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26(2):191-208. doi:10.1080/009262300278597
- Yang X, Zhu L, Wang YJ, et al. Comparison of the modified laparoscopic Vecchietti and Davydov colpoplasty techniques in Mayer-Rokitansky-Küster-Hauser syndrome: A long-term follow-up analysis. J Obstet Gynaecol Res. 2022;48(7):1930-1937. doi:10.1111/jog.15262
Year 2022,
Volume: 7 Issue: 4, 631 - 635, 10.12.2022
Abstract
A-21 year-old woman diagnosed with Meyer Rokitamsky Kuster Hauser syndrome has presented with a complaint of amenorrhea and failure to have vaginal penetration during coitus. On magnetic resonance imaging, bilateral rudimentary uterine remnants next to normal-appearing ovaries with absence of uterus have been detected. Laparoscopically, a 3 cm transverse incision was made pelvic peritoneum and vaginal apex to create a two-finger width opening to the blind vagina. Anterior and posterior visceral peritoneal edges have been grasped and sutured vaginally to the vaginal epithelial border. A continuous purse string stitch technique has been utilized to close the proximal part of the neovagina. The postoperative course of the patient was uneventful. The patient kept using a vaginal silicone dilatator every night for 3 months and she was allowed to have regular coital activity after then. The modified Davydov procedure is an efficient surgical technique with lower complication rates and vaginal stenosis rates.
Keywords
Project Number
-
References
- Davydov SN, Zhvitiascvili OD. Formation of vagina (colpopoiesis) from peritoneum of Douglas pouch. Acta Chir Plast. 1974;16(1):35-41.
- Adamyan LV, Kulakov VI, Murvatov KD, Zurabiani Z. Application of endoscopy in surgery for malformations of genitalia. J Am Assoc Gynecol Laparosc.1994;1(4, Part 2):1. doi:10.1016/s1074-3804(05)80868-0
- Fedele L, Frontino G, Restelli E, Ciappina N, Motta F, Bianchi S. Creation of a neovagina by Davydov's laparoscopic modified technique in patients with Rokitansky syndrome. Am J Obstet Gynecol. 2010;202(1):33.e1-6. doi:10.1016/j.ajog.2009.08.035
- Dargent D, Marchiolè P, Giannesi A, Benchaïb M, Chevret-Méasson M, Mathevet P. Laparoscopic Davydov or laparoscopic transposition of the peritoneal colpopoiesis described by Davydov for the treatment of congenital vaginal genesi: the technique and its evolution. Gynecol Obstet Fertil. 2004;32(12):1023-1030.
- Darai E, Toullalan O, Besse O, Potiron L, Delga P. Anatomic and functional results of laparoscopic-perineal neovagina construction by sigmoid colpoplasty in women with Rokitansky’s syndrome. Hum Reprod. 2003;18(11):2454-2459.
- Giannesi A, Marchiole P, Benchaib M, Chevret-Measson M, Mathevet P, Dargent D. Sexuality after laparoscopic Davydov in patients affected by congenital complete vaginal agenesis associated with uterine agenesis or hypoplasia. Hum Reprod. 2005;20(10):2954-2957.
- Ismail IS, Cutner AS, Creighton SM. Laparoscopic vaginoplasty: Alternative techniques in vaginal reconstruction. BJOG. 2006;113(3):340-343. doi:10.1111/j.1471-0528.2005.00845.x
- Templeman CL, Hertweck SP, Levine RL, Reich H. Use of laparoscopically mobilized peritoneum in the creation of a neovagina. Fertil Steril. 2000;74(3):589-592. doi:10.1016/s0015-0282(00)00700-7.74:589-92
- Rosen R, Brown C, Heiman J, et al. The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26(2):191-208. doi:10.1080/009262300278597
- Yang X, Zhu L, Wang YJ, et al. Comparison of the modified laparoscopic Vecchietti and Davydov colpoplasty techniques in Mayer-Rokitansky-Küster-Hauser syndrome: A long-term follow-up analysis. J Obstet Gynaecol Res. 2022;48(7):1930-1937. doi:10.1111/jog.15262
There are 10 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Case report |
| Authors | |
| Project Number | - |
| Early Pub Date | December 3, 2022 |
| Publication Date | December 10, 2022 |
| Submission Date | August 31, 2022 |
| Acceptance Date | October 12, 2022 |
| Published in Issue | Year 2022 Volume: 7 Issue: 4 |
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