title: Impact of human papillomavirus infection on the neovaginal and vulval tissues of women who underwent surgical treatment for Mayer-Rokitansky-Kuster-Hauser syndrome.
abstract: OBJECTIVE
  To evaluate the impact of human papillomavirus (HPV) infections on the neovaginal and vulval tissues of women who underwent surgical treatment for Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome.
  
  
  METHODS
  Multicenter observational study.
  
  
  METHODS
  University and community hospitals.
  
  
  METHODS
  Thirty-three women who had previously undergone neovagina reconstruction due to MRKH and who were referred to our centers for the evaluation and treatment of HPV neovaginal/vulval-related lesions.
  
  
  METHODS
  HPV infections were confirmed by polymerase chain reaction analysis or hybrid capture 2 tests; the patients underwent vaginoscopy, pap smear, and biopsy of the lesion and were treated by laser vaporization. Follow-up was conducted for 5 years.
  
  
  METHODS
  HPV-related neovaginal/vulval lesions, HPV testing, follow-up, recurrence rate.
  
  
  RESULTS
  Seventeen patients showed vulval lesions, and 16 patients neovaginal lesions. HPV testing results were positive for low-risk HPVs in 27 patients and high-risk HPVs in six patients. All the vulval lesions were condylomata, whereas 10 neovaginal lesions were condylomata, three were vaginal intraepithelial neoplasia (VAIN) degree 1, two were VAIN degree 2, and one was an adenocarcinoma. Eight patients were lost to follow-up. Twenty patients tested positive for an HPV infection, and seven patients (28%) had a recurrence of the lesion in the follow-up time.
  
  
  CONCLUSIONS
  Patients who underwent neovagina reconstruction have sexual relationships and are HPV exposed. These patients should be evaluated after surgery for HPV infections to prevent HPV-related diseases and cancers.
authors.affiliation: Department of Woman's Health and Territorial Medicine, Faculty of Medicine and Psychology, University of Rome La Sapienza, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Frega
authors.forename: Paolo
authors.initials: P
authors.lastname: Scirpa
authors.forename: Francesco
authors.initials: F
authors.lastname: Sopracordevole
authors.forename: Alberto
authors.initials: A
authors.lastname: Biamonti
authors.forename: Paola
authors.initials: P
authors.lastname: Bianchi
authors.forename: Luana
authors.initials: L
authors.lastname: De Sanctis
authors.forename: Laura
authors.initials: L
authors.lastname: Lorenzon
authors.forename: Arianna
authors.initials: A
authors.lastname: Pacchiarotti
authors.forename: Deborah
authors.initials: D
authors.lastname: French
authors.forename: Massimo
authors.initials: M
authors.lastname: Moscarini
mesh_terms: D058489:46, XX Disorders of Sex Development / Q000473:pathology / Q000601:surgery*; D000015:Abnormalities, Multiple / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000013:Congenital Abnormalities; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000002:abnormalities; D009095:Mullerian Ducts / Q000002:abnormalities; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000517:prevention & control*; D019651:Plastic Surgery Procedures / Q000379:methods*; D019170:Somites / Q000002:abnormalities; D013131:Spine / Q000002:abnormalities; D014599:Uterus / Q000002:abnormalities / Q000473:pathology / Q000601:surgery; D014621:Vagina / Q000002:abnormalities / Q000473:pathology / Q000601:surgery*; D014844:Vulva / Q000473:pathology / Q000601:surgery*; D055815:Young Adult