Öz
Özet
Mayer-Rokitansky-Küster-Hauser (MRKH) sendromu, uterovajinal ageneziye bağlı primer amenorenin nadir bir konjenital nedenidir. Yeniden vajen oluşturulmasında kulanılan çeşitli cerrahi teknikler vardır. Sigmoid greft uygulaması, yeterli uzunluğun sağlanabilmesi, doğal lubrikasyon ve erken cinsel fonksiyon kazanımı açısından en iyi yöntem olarak görülmektedir. Yirmi sekiz yaşında primer amenore ve ilk evliliğinde başarısız koitus öyküsü bulunan hastamız, vajinoplasti isteği ile kliniğimize başvurdu. Olguya sigmoid vajinoplasti operasyonu yapıldı. Postoperatif altıncı ayda evlilik yaptı ve 1.5 yıllık takipte herhangi bir komplikasyon görülmedi.
Anahtar sözcükler: Mayer-Rokitansky-Küstner-Hauser sendromu, sigmoid vajinoplasti
Abstract
The Mayer-Rokitansky-Küstner-Hauser (MRKH) syndrome is a rare congenital cause of primary amenorrhea, due to uterovaginal agenesis. Several surgical techniques have been used to create a neovagina. Neovagina construction with a sigmoid graft appears to be the best option, as it offers adequate length and natural lubrication, allowing early intercourse. A 28 years old women presented to our clinic with primary amenore and unsuccessful coitus at her first marriage whishing vaginoplasty. Sigmoid vaginoplasty performed for the patient. Six months after the operation our case had a marriage. For the one and a half year follow up no complication observed.
Keywords: Mayer-Rokitansky-Kustner-Hauser syndrome, sigmoid vaginoplastyAnahtar Kelimeler
Kaynakça
- Kapoor R, Sharma DK, Singh KJ, Suri A, Sıngh P, Chaudhary H, Dubey D, Mandhani A. Sigmoid vaginoplasty: Long-Term results. Urology 2006; 67: 1212-5.
- Şatıroğlu H, Berker B. Jinekolojik ve Obstetrikal Cerrahi. Güner H, Editör: Müllerien Anomaliler ve Cerrahi Tedavileri. 1. Baskı. Ankara: Güneş Kitabevi; 2005, p: 701-6.
- Flack CE, Barraza MA, Steven PS. Vaginoplasty: combination therapy using labia minora flaps and Lucite dilators-preliminary report. J Urol 1993; 150: 654-6.
- Banister JB, McIndoe AH. Congenital Absence of the Vagina, treated by Means of an Indwelling Skin-Graft. Proc R Soc Med. 1938 ;31: 1055-6.
- Martinez-Mora J, Isnard R, Castellvi A, López Ortiz P. Neovagina in vaginal agnesis: surgical methods and long term results. J Pediatr Surg 1992; 27: 10-4.
- Ashworth MF, Morton KE, Dewhurst J, Lilford RJ, Bates RG. Vaginoplasty using amnion. Obstet Gynecol 1986; 67: 443-6.
- Moudouni S, Koutani A, Attya AI, Hachimi M and Lakrissa A. The use of isolated sigmoid colon segment for vaginal replacement in young adults. International Urology and Nephrology 2004; 36: 567-71.
- Goligher JC. The use of pedicled trasplants of sigmoid or other parts of the intestinal tract for vaginal construction. Ann Roy Coll Surg Engl 1983; 65: 353.
- Turner-Warwick R, Kırby RS. The construction and reconstruction of the vagina with the colocecum. Surg Gynec Obst 1990; 170: 132.
- de Souza AZ, Maluf M, Perin PM, Maluf Filho F, Perin LF. Surgical treatment of congenital uterovaginal agenesis: Mayer-Rokiyansky-Kuster-Hauser syndrome. Int Surg 1987; 72: 45-7.
- Hensle TW, Reiley EA. Vaginal replacement in children and young adults. J Urol 1998; 159: 1035-8.
- Pratt JH. Vaginal atresia corrected by the use of small and large bowel. Clin Obstet Gynecol 1972; 15: 639.
- Rajimwale A, Furness III PD, Brant WO, Koyle MA. Vaginal construction using sigmoid colon in children and young adults. BJU international 2004; 94: 115-9.
- Hanna MK. Vaginal construction. Urology 1987; 29: 272-5.
- Tillem SM, Stock JA and Hanna MK. Vaginal construction in children. J Urol 1998; 160: 186-90.
- Yokomizo R, Murakami T, Naitou H, Yamada A. Treatment for prolapse of the sigmoid neovagina in Mayer-Rokitansky-Kuster-Hauser syndrome. Obstet Gynecol 2002; 100: 1085-7.
Öz
Mayer-Rokitansky-Kuster-Hauser (MRKH) sendromu, uterovaginal ageneze bağlı primer amenorenin nadir bir konjenital sebebidir. Yeniden vajen oluşturulmasında kulanılan çeşitli cerrahi teknikler vardır. Sigmoid greft uygulaması, yeterli uzunluğun sağlanabilmesi, doğal lubrikasyon ve erken cinsel fonksiyon kazanımı açısından en iyi yöntem olarak görülmektedir. 28 yaşında primer amenore ve başarısız koitus öyküsü bulunan hastamız, vajinoplasti isteği ile kliniğimize başvurdu. Olguya sigmoid vajinoplasti operasyonu yapıldı. Postoperatif 6. ayda evlilik yaptı. 1.5 yıllık takipte herhangi bir komplikasyon görülmedi.
Anahtar Kelimeler
Mayer-Rokitansky-Küstner-Hauser sendromu sigmoid vajinoplasti
Kaynakça
- Kapoor R, Sharma DK, Singh KJ, Suri A, Sıngh P, Chaudhary H, Dubey D, Mandhani A. Sigmoid vaginoplasty: Long-Term results. Urology 2006; 67: 1212-5.
- Şatıroğlu H, Berker B. Jinekolojik ve Obstetrikal Cerrahi. Güner H, Editör: Müllerien Anomaliler ve Cerrahi Tedavileri. 1. Baskı. Ankara: Güneş Kitabevi; 2005, p: 701-6.
- Flack CE, Barraza MA, Steven PS. Vaginoplasty: combination therapy using labia minora flaps and Lucite dilators-preliminary report. J Urol 1993; 150: 654-6.
- Banister JB, McIndoe AH. Congenital Absence of the Vagina, treated by Means of an Indwelling Skin-Graft. Proc R Soc Med. 1938 ;31: 1055-6.
- Martinez-Mora J, Isnard R, Castellvi A, López Ortiz P. Neovagina in vaginal agnesis: surgical methods and long term results. J Pediatr Surg 1992; 27: 10-4.
- Ashworth MF, Morton KE, Dewhurst J, Lilford RJ, Bates RG. Vaginoplasty using amnion. Obstet Gynecol 1986; 67: 443-6.
- Moudouni S, Koutani A, Attya AI, Hachimi M and Lakrissa A. The use of isolated sigmoid colon segment for vaginal replacement in young adults. International Urology and Nephrology 2004; 36: 567-71.
- Goligher JC. The use of pedicled trasplants of sigmoid or other parts of the intestinal tract for vaginal construction. Ann Roy Coll Surg Engl 1983; 65: 353.
- Turner-Warwick R, Kırby RS. The construction and reconstruction of the vagina with the colocecum. Surg Gynec Obst 1990; 170: 132.
- de Souza AZ, Maluf M, Perin PM, Maluf Filho F, Perin LF. Surgical treatment of congenital uterovaginal agenesis: Mayer-Rokiyansky-Kuster-Hauser syndrome. Int Surg 1987; 72: 45-7.
- Hensle TW, Reiley EA. Vaginal replacement in children and young adults. J Urol 1998; 159: 1035-8.
- Pratt JH. Vaginal atresia corrected by the use of small and large bowel. Clin Obstet Gynecol 1972; 15: 639.
- Rajimwale A, Furness III PD, Brant WO, Koyle MA. Vaginal construction using sigmoid colon in children and young adults. BJU international 2004; 94: 115-9.
- Hanna MK. Vaginal construction. Urology 1987; 29: 272-5.
- Tillem SM, Stock JA and Hanna MK. Vaginal construction in children. J Urol 1998; 160: 186-90.
- Yokomizo R, Murakami T, Naitou H, Yamada A. Treatment for prolapse of the sigmoid neovagina in Mayer-Rokitansky-Kuster-Hauser syndrome. Obstet Gynecol 2002; 100: 1085-7.
Ayrıntılar
| Birincil Dil | turc |
|---|---|
| Bölüm | Olgu Sunumları |
| Yazarlar | |
| Yayımlanma Tarihi | 11 Mart 2010 |
| Yayımlandığı Sayı | Yıl 2010Cilt: 32 Sayı: 1 |