title: [Flexible vaginal cast covered with oxidated cellulose. Surgical option in neovagina for patients with Rokitansky-Kuster-Hauser syndrome].
abstract: The alterations in differentiation of the mullerian derivatives and urogenital sinus are a frequent cause of demanding attention in the gynecologist office. Vaginal agenesis and hypoplasia are the representative events of alterations of human sexual differentiation. Handling such conditions is in direct relationship to the magnitude of the anatomical damage and the biopsychosocial consequences of such pathologies. From historical perspective, several surgical techniques of neovagina to correct such alterations have been described. We are presenting our experience in surgical treatment of vaginal agenesis, as well as the aesthetic-functional outcomes obtained from a highly specialized hospital of the Health Sector in Mexico City. Our patients attended the gynecologist office mainly because of primary amenorrhea, anatomical alterations and sexual dysfunction. Tbe age range varied between 19 and 28 years. Basic laboratory tests were conducted. Urography, genetic studies, and a laparoscopic procedure were included. All the women received psychological support. The diagnosis in all the cases was Rokitansky Kuster-Hauser Syndrome with agenesis of the 2 proximal thirds of vagina. A neovagina assisted by laparoscopy using a technique previously modified was conducted. In such technique we use a flexible vaginal mould and oxide cellulose to prevent fibrosis and surgical retraction. Cosmetic outcome was satisfactory and dysfunction sexual was all improved. We conclude that our procedure that includes the neovagina assisted by laparoscopy and the use of a vaginal mould and oxide cellulose is a surgical option in those patients presenting with vaginal agenesis and hypoplasia. This procedure improves the aesthetic and sexual performances that are profoundly altered in such patients.
authors.affiliation: Departamento de Biología de la Reproducción, Hospital de Ginecobstetricia, 3 Centro Médico Nacional La Raza I.M.S.S. México, D.F.
authors.forename: A
authors.initials: A
authors.lastname: Estrada Portilla
authors.forename: V S
authors.initials: VS
authors.lastname: Vital Reyes
authors.forename: S
authors.initials: S
authors.lastname: Téllez Velasco
authors.forename: J C
authors.initials: JC
authors.lastname: Hinojosa Cruz
authors.forename: Y C
authors.initials: YC
authors.lastname: Cárdenas Pérez
mesh_terms: D000015:Abnormalities, Multiple; D000328:Adult; D002482:Cellulose; D005260:Female; D006801:Humans; D009095:Mullerian Ducts / Q000002:abnormalities*; D010084:Oxidation-Reduction; D013577:Syndrome; D014599:Uterus / Q000002:abnormalities*; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery*
chemical_list: D002482:Cellulose