Vaginoplasty with oxidized cellulose: anatomical, functional and histological evaluation

Vaginoplasty with oxidized cellulose: anatomical, functional and histological evaluation

Author Dornelas, Juliane Autor UNIFESP Google Scholar
Jarmy-Di Bella, Zsuzsanna I. K. Autor UNIFESP Google Scholar
Heinke, Thais Autor UNIFESP Google Scholar
Kajikawa, Marcio M. Autor UNIFESP Google Scholar
Takano, Claudia C. Autor UNIFESP Google Scholar
Zucchi, Eliana V. M. Autor UNIFESP Google Scholar
Girao, Manoel J. B. C. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Objective: To present and evaluate the histological, anatomical and functional results of the McIndoe procedure, as modified by the application of oxidized cellulose (Surgicel (TM)) in women with vaginal agenesis.Study design: Eleven patients with vaginal agenesis underwent vaginoplasty using a mould that had been wrapped with oxidized cellulose. the surgeries were performed between January 2009 and January 2010. Eight of the patients had been diagnosed with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome, and the remaining three had been diagnosed with cervicovaginal agenesis (CVA). the mean follow-up time was 14 months (range, 6-24 months), and it included clinical examinations and evaluation of the Female Sexual Function Index (FSFI). Neovaginal biopsies were taken at the time of surgery and 1-12 months after surgery. the histology of the samples was evaluated to determine squamous epithelialization of the neovaginal tissue over time, and the total collagen content of the neovaginas were compared with normal control subjects. for statistical analysis we employed the ANOVA test and the t-test.Results: At 6 months, anatomical success was achieved in 100% of the MRKH syndrome patients (neovaginal length >= 6 cm), and functional success was achieved in 100% of the patients who started their sexual life (FSFI score >= 30). Biopsy results showed complete epithelialization of the neovagina after 5 months in all samples, and the collagen content was comparable to that of a normal vagina. One major postoperative complication occurred in a patient with CVA, which culminated in death. the uterovaginal canalization procedure was unsuccessful at creating an outflow tract for regular menses in all cases.Conclusions: the procedure described here offers patients a functional vagina by means of a simple and low-cost procedure that elicits squamous epithelialization of the neovaginal vault, with total collagen content similar to that of normal vaginal tissue. It is a potential alternative therapeutic approach for MRKH syndrome but not applicable to cases of CVA. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
Keywords Vaginal agenesis
Oxidized cellulose
Vaginoplasty
Collagen
Language English
Date 2012-08-01
Published in European Journal of Obstetrics & Gynecology and Reproductive Biology. Amsterdam: Elsevier B.V., v. 163, n. 2, p. 204-209, 2012.
ISSN 0301-2115 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 204-209
Origin http://dx.doi.org/10.1016/j.ejogrb.2012.04.018
Access rights Closed access
Type Article
Web of Science ID WOS:000308787000016
URI http://repositorio.unifesp.br/handle/11600/35134

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