title: Laparoscopic promontofixation for the treatment of recurrent sigmoid neovaginal prolapse: case report and systematic review of the literature.
abstract: Prolapse of a sigmoid neovagina, created in patients with congenital vaginal aplasia, is rare. In correcting this condition, preservation of coital function and restoration of the vaginal axis should be of primary interest. A 34-year-old woman with vaginal agenesis underwent vaginoplasty using sigmoid colon. Almost 6 years after the initial operation, she started complaining of a bearing-down sensation and an increase in vaginal discharge. She underwent 2 open surgeries and one vaginal surgery to treat the prolapse with no success. She came to our service and at vaginal examination the neovagina protruded approximately 5 cm beyond the hymen. The prolapse was treated successfully using a laparoscopic approach to suspend the neovagina to the sacral promontory (laparoscopic promontofixation). Prolapse of an artificially created vagina is a rare occurrence, without a standard treatment. Laparoscopy may be an alternative approach to restore the neovagina without compromising its function.
authors.affiliation: Department of General Surgery and Gynecology, Cruz Vermelha Hospital, Curitiba, Paraná, Brazil. williamkondo@yahoo.com
authors.forename: William
authors.initials: W
authors.lastname: Kondo
authors.forename: Reitan
authors.initials: R
authors.lastname: Ribeiro
authors.forename: Fernanda Keiko
authors.initials: FK
authors.lastname: Tsumanuma
authors.forename: Monica Tessmann
authors.initials: MT
authors.lastname: Zomer
mesh_terms: D000328:Adult; D012809:Colon, Sigmoid / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D056887:Pelvic Organ Prolapse / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D012447:Sacrum / Q000601:surgery; D014564:Urogenital Abnormalities / Q000150:complications / Q000601:surgery*; D014621:Vagina / Q000002:abnormalities / Q000601:surgery*