Early prolapse of a neovagina created with self-dilatation and treated with sacrospinous ligament suspension in a patient with Mayer-Rokitansky-Küster-Hauser syndrome: a case report.
OBJECTIVE
To report a case of a patient who had an early prolapse of the neovagina, while using Frank's dilators method, that was successfully treated with sacrospinous ligament suspension.


METHODS
Case report.


METHODS
Tertiary-care university hospital.


METHODS
A 22-year-old woman with Mayer-Rokitansky-Küster-Hauser syndrome.


METHODS
Frank's vaginal dilators method.


METHODS
Vaginal elongation by self-dilatation. Early prolapse of the neovagina. Surgical repair with vaginal sacrospinous ligament suspension.


RESULTS
A few months after the beginning of the treatment the patient had a prolapse of the neovagina. On pelvic examination, the total vaginal length was 5 cm with eversion of the vaginal apex 3 cm beyond the hymen with strain. Vaginal length was not satisfactory for the patient yet; therefore, the vaginal dilation program was continued to reach the prefixed vaginal length. Two months later the total vaginal length was 8 cm with eversion of the vaginal apex 6 cm beyond the hymen with strain. The patient underwent a sacrospinous ligament suspension. Twenty months after surgery, the patient had no symptoms and was highly satisfied with the result.


CONCLUSIONS
Prolapse of a neovagina may occur early after conservative treatment. If the initial prefixed goal of vaginal length has not been reached when prolapse develops, the vaginal dilatation program may be continued. In our case vaginal sacrospinous ligament fixation was successful, with good anatomic and functional results.
Calcagno
Marco
M
Department of Obstetrics and Gynecology, University La Sapienza, Rome, Italy. marco.calcagno@uniroma1.it
Pastore
Maria
M
Bellati
Filippo
F
Plotti
Francesco
F
Maffucci
Diana
D
Boni
Terenzio
T
Benedetti Panici
Pierluigi
P
D004106:Dilatation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008022:Ligaments / Q000601:surgery; D009095:Mullerian Ducts / Q000002:abnormalities*; D017060:Patient Satisfaction; D012648:Self Care / Q000009:adverse effects*; D019738:Surgically-Created Structures; D013536:Suture Techniques; D013577:Syndrome; D013997:Time Factors; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000209:etiology / Q000601:surgery*; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery*; D055815:Young Adult