title: A Simple Laparoscopic Procedure to Restore a Normal Vaginal Length After Colpohysterectomy With Large Upper Colpectomy for Cervical and/or Vaginal Neoplasia.
abstract: Colpohysterectomy is sometimes associated with a large upper colpectomy resulting in a shortened vagina, potentially impacting sexual function. We report on a preliminary experience of a laparoscopic colpoplasty to restore a normal vaginal length. Patients with shortened vaginas after a laparoscopic colpohysterectomy were considered for a laparoscopic modified Davydov's procedure to create a new vaginal vault using the peritoneum of the rectum and bladder. From 2010 to 2014, 8 patients were offered this procedure, after informed preoperative consent. Indications were 2 extensive recurrent vaginal intraepithelial neoplasias grade 3 and 6 radical hysterectomies for cervical cancer. Mean vaginal length before surgery was 3.8 cm (standard deviation, 1.6). Median operative time was 50 minutes (range, 45-90). Blood loss was minimal (50-100 mL). No perioperative complications occurred. Median vaginal length at discharge was 11.3 cm (range, 9-13). Sexual intercourse could be resumed around 10 weeks after surgery. At a median follow-up of 33.8 months (range, 2.4-51.3), 6 patients remained sexually active but 2 had stopped. Although this experience is small, this laparoscopic modified Davydov's procedure seems to be an effective procedure, adaptable to each patient's anatomy. If the initial postoperative regular self-dilatation is carefully observed, vaginal patency is durably restored and enables normal sexual function.
authors: Department of Gynecologic Oncology, Centre Oscar Lambret, Lille, France. Electronic address: e-leblanc@o-lambret.fr.
authors: Eric
authors: E
authors: Leblanc
authors: Department of Gynecologic Oncology, Centre Oscar Lambret, Lille, France.
authors: Lucie
authors: L
authors: Bresson
authors: Department of Gynecologic Oncology, Centre Oscar Lambret, Lille, France.
authors: Benjamin
authors: B
authors: Merlot
authors: Department of Gynecologic Oncology, Centre Oscar Lambret, Lille, France.
authors: Marco
authors: M
authors: Puga
authors: Department of Gynecologic Oncology, CHU ND des Bruyères, Chênée-Liège, Belgium.
authors: Frederic
authors: F
authors: Kridelka
authors: Department of Gynecologic Oncology, Barretos Cancer Center, Barretos, Brazil.
authors: Audrey
authors: A
authors: Tsunoda
authors: Department of Gynecologic Oncology, Centre Oscar Lambret, Lille, France.
authors: Fabrice
authors: F
authors: Narducci
mesh_terms: D000328:Adult; D000368:Aged; D003075:Coitus; D020884:Colpotomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010537:Peritoneum / Q000601:surgery; D011247:Pregnancy; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D014621:Vagina / Q000473:pathology / Q000601:surgery; D014625:Vaginal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*
keywords: Colpohysterectomy; Colpoplasty; Davydov; Laparoscopy; Vaginoplasty