title: Opening the Anterior Vaginal Vault: A Novel Approach to Vaginoplasty with a Modified McIndoe Procedure Using an Artificial Dermis.
abstract: BACKGROUND
  Although preparation of a potential vaginal space between the bladder and rectum is a pivotal step in various vaginal reconstructions for patients with vaginal agenesis, few papers have mentioned the importance of this procedure.
  
  
  METHODS
  We report the successful creation of a neovagina in 3 Japanese patients with Mayer-Rokitansky-Küster-Hauser syndrome using a novel modified McIndoe procedure that involved separation between the bladder and the rudimentary uterus in a laparoscopically assisted manner.
  
  
  CONCLUSIONS
  Opening "the anterior vaginal vault" between the bladder and uterus is a novel concept of vaginal reconstruction; this approach has not been described hitherto in the literature. Based on the outcome of our cases, we conclude that this procedure is advantageous in creating a large and soft neovagina.
authors.affiliation: Department of Obstetrics and Gynecology, Okayama University Hospital, Okayama, Japan. Electronic address: ykamada@md.okayama-u.ac.jp.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kamada
authors.affiliation: Department of Obstetrics and Gynecology, Okayama University Hospital, Okayama, Japan; Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
authors.forename: Ai
authors.initials: A
authors.lastname: Sakamoto
authors.affiliation: Department of Obstetrics and Gynecology, Okayama University Hospital, Okayama, Japan; Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Tabuchi
authors.affiliation: Department of Obstetrics and Gynecology, Okayama University Hospital, Okayama, Japan; Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
authors.forename: Miwa
authors.initials: M
authors.lastname: Matsuda
authors.affiliation: Department of Obstetrics and Gynecology, Okayama University Hospital, Okayama, Japan; Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Department of Obstetrics and Gynecology, Okayama University Hospital, Okayama, Japan; Graduate School of Health Sciences, Okayama University, Okayama, Japan.
authors.forename: Mikiya
authors.initials: M
authors.lastname: Nakatsuka
authors.affiliation: Department of Obstetrics and Gynecology, Okayama University Hospital, Okayama, Japan; Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hiramatsu
mesh_terms: D058489:46, XX Disorders of Sex Development / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D044466:Asian People; D000013:Congenital Abnormalities / Q000601:surgery*; D020405:Dermis / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D009095:Mullerian Ducts / Q000002:abnormalities* / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D019738:Surgically-Created Structures; D001743:Urinary Bladder / Q000601:surgery; D014621:Vagina / Q000002:abnormalities / Q000601:surgery*; D055815:Young Adult
keywords: Anterior vaginal vault; Artificial dermis; Neovagina; Potential vaginal space; Vaginal agenesis; Vaginal canal; Vaginoplasty