title: Total Laparoscopic Colocolpopoiesis in a Kidney Transplant Recipient With Frasier Syndrome.
abstract: BACKGROUND
  The absence of a normal functioning vagina can have a profound impact on women's quality of life and psychological well being. Frasier syndrome is a rare autosomal recessive disorder which presents with male pseudohermaphroditism with gonadal dysgenesis, renal failure in early adulthood and increased risk of developing gonadoblastoma. Kidney transplant recipients are reported to have a high complication rate after colorectal surgery, most probably resulting from immunosuppressive therapy.
  
  
  METHODS
  A 25-year-old female kidney transplant recipient with Frasier syndrome consulted our department to discuss the possibilities of surgically constructing a functional vagina. She successfully underwent a total laparoscopic colocolpopoiesis without any complications. A sigmoid segment of 16 cm long was isolated laparoscopically and transferred caudally in a dissected pouch between bladder and rectum on its vascular pedicle. There was no short-term morbidity and no complications up to 3 years postoperatively. She experienced no neovaginal symptoms and was able to engage in neovaginal penetration by means of vibrator or neovaginal dilatator.
  
  
  CONCLUSIONS
  The positive results in this patient lead us to recommend laparoscopic colocolpopoiesis in kidney transplant patients who are seeking vaginoplasty. We advocate considering a total laparoscopic approach whenever rectosigmoid colocolpopoiesis is indicated, even after a kidney transplantation.
authors.affiliation: From the *Department of Plastic, Reconstructive and Hand Surgery, †Center of Expertise on Gender Dysphoria, ‡Department of Nephrology, VU University Medical Center, Amsterdam; §Department of Nephrology, Zaans Medical Center, Zaandam; and ∥Department of Gastro-Intestinal Surgery and Advanced Laparoscopy, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Mark-Bram
authors.initials: MB
authors.lastname: Bouman
authors.forename: Wouter B
authors.initials: WB
authors.lastname: van der Sluis
authors.forename: Shaikh A
authors.initials: SA
authors.lastname: Nurmohamed
authors.forename: Anne
authors.initials: A
authors.lastname: van Tellingen
authors.forename: Wilhelmus Jhj
authors.initials: WJ
authors.lastname: Meijerink
mesh_terms: D000328:Adult; D001187:Artificial Organs; D012809:Colon, Sigmoid / Q000637:transplantation*; D005260:Female; D052159:Frasier Syndrome / Q000601:surgery*; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy / Q000379:methods; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery*