title: Creation of a neovagina in a patient with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome and previously corrected rectovestibular fistula concomitant with imperforate anus.
abstract: BACKGROUND
  Congenital absence of uterus and vagina (CAUV) when associated with anorectal malformations is usually diagnosed and repaired in infancy at the time of anorectoplasty. Long-term observations of patients are scarce and do not justify early vaginal reconstruction. Question arises whether creation of a neovagina can be safely and successfully performed when the patient is mature.
  
  
  METHODS
  The patient, diagnosed with MRKH syndrome at 16 years of age, underwent repair of rectovestibular fistula and imperforate anus ("cut-back" procedure, temporal sigmostomy and sagittal anterior anorectoplasty) in infancy. At 18, modified Wharton vaginoplasty was performed with a good anatomico-functional outcome.
  
  
  CONCLUSIONS
  Early repair of anorectal malformation and postponed vaginal reconstruction seem to be a viable option for patients with congenital rectovestibular fistula and anal atresia concomitant with CAUV.
authors.affiliation: Division of Gynecology, Department of Perinatology and Gynecology, Poznan University of Medical Sciences, Poznan, Poland. Electronic address: karkap@umed.poznan.pl.
authors.forename: Karina
authors.initials: K
authors.lastname: Kapczuk
authors.affiliation: Division of Gynecology, Department of Perinatology and Gynecology, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Friebe
authors.affiliation: Division of Gynecology, Department of Perinatology and Gynecology, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Kinga
authors.initials: K
authors.lastname: Iwaniec
authors.affiliation: Division of Gynecology, Department of Perinatology and Gynecology, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Witold
authors.initials: W
authors.lastname: Kędzia
mesh_terms: D058489:46, XX Disorders of Sex Development / Q000150:complications / Q000601:surgery*; D000293:Adolescent; D001006:Anus, Imperforate / Q000150:complications / Q000601:surgery*; D000013:Congenital Abnormalities / Q000601:surgery*; D005260:Female; D006801:Humans; D009095:Mullerian Ducts / Q000002:abnormalities* / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012006:Rectovaginal Fistula / Q000150:complications / Q000601:surgery*; D014621:Vagina / Q000002:abnormalities / Q000601:surgery*
keywords: Anal atresia; Anorectal malformation; Mayer-rokitansky-kuster-hauser syndrome; Vaginal aplasia