title: Less invasive new vaginoplasty using laparoscopy, atelocollagen sponge, and hand-made mould.
abstract: OBJECTIVE
  The purpose of this study was to validate the therapeutic efficacy of the innovative surgical approach using laparoscopy, atelocollagen sponge, and hand-made mould on the achievement of a satisfactory neovagina in patients with vaginal agenesis.
  
  
  METHODS
  The current study involved four patients diagnosed as having Mayer-Rokitansky-Küster-Hauser syndrome. After creating a vaginal tunnel, the mould wrapped with atelocollagen sponge was placed within the neovagina. The hand-made mould made of expanded polystyrene was started to insert into the neovagina at 7 days after operation. Since this mould is lighter and easier to adjust compared with the previous commercialized ones, it was less stressful for the patients to master the procedure than previous methods.
  
  
  RESULTS
  Average operation time was 124 minutes with average blood loss being 45 ml. Average hospital stay was 23 days. The mean length of the neovagina one week postoperation was 8 cm with two fingers in width in all patients. No remarkable postoperative complications were noted. At two months after surgery, the neovagina was confirmed to be completely epithelialized in all patients, assessed by Schiller's test.
  
  
  CONCLUSIONS
  This innovative surgical procedure using a mould wrapped with atelocollagen sponge may be a more useful approach for the treatment of vaginal agenesis.
authors.affiliation: Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan. ymiya@med.kobe-u.ac.jp
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Miyahara
authors.forename: Shigeki
authors.initials: S
authors.lastname: Yoshida
authors.forename: Tokuro
authors.initials: T
authors.lastname: Shirakawa
authors.forename: Natsuko
authors.initials: N
authors.lastname: Makihara
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Niiya
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Ebina
authors.forename: Hideto
authors.initials: H
authors.lastname: Yamada
mesh_terms: D058489:46, XX Disorders of Sex Development / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D003075:Coitus; D003094:Collagen; D000013:Congenital Abnormalities / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation* / Q000379:methods*; D009095:Mullerian Ducts / Q000002:abnormalities* / Q000601:surgery; D011137:Polystyrenes; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery*; D055815:Young Adult
chemical_list: D011137:Polystyrenes; C059821:atelocollagen; D003094:Collagen