title: Creation of a Neovagina by Laparoscopic Modified Vecchietti Technique: Anatomic and Functional Results.
abstract: PurposeTo evaluate the anatomic and functional results of a laparoscopic modified Vecchietti technique for the creation of a neovagina in patients with congenital vaginal aplasia.MethodsRetrospective study of nine patients with congenital vaginal aplasia submitted to the laparoscopic Vecchietti procedure, in our department, between 2006 and 2013. The anatomical results were evaluated by assessing the length, width and epithelialization of the neovagina at the postoperative visits. The functional outcome was evaluated using the Rosen Female Sexual Function Index (FSFI) questionnaire and comparing the patients' results to those of a control group of 20 healthy women. The statistical analysis was performed using SPSS Statistics version 19.0 (IBM, Armonk, NY, USA), Student t-test, Mann-Whitney U test and Fisher exact test.ResultsThe condition underlying the vaginal aplasia was Mayer-Rokitansky-Küster-Hauser syndrome in eight cases, and androgen insensitivity syndrome in one case. The average preoperative vaginal length was 2.9 cm. At surgery, the mean age of the patients was 22.2 years. The surgery was performed successfully in all patients and no intra or postoperative complications were recorded. At the first postoperative visit (6 to 8 weeks after surgery), the mean vaginal length was 8.1 cm. In all cases, the neovagina was epithelialized and had an appropriate width. The mean FSFI total and single domain scores did not differ significantly from those of the control group: 27.5 vs. 30.6 (total); 4.0 vs. 4.2 (desire); 4.4 vs. 5.2 (arousal); 5.2 vs. 5.3 (lubrication); 4.2 vs. 5.0 (orgasm); 5.3 vs. 5.5 (satisfaction) and 4.4 vs. 5.4 (comfort).ConclusionsThis modified laparoscopic Vecchietti technique is a simple, safe and effective procedure, which allows patients with congenital vaginal aplasia to have a satisfactory sexual activity, comparable to that of normal controls.
authors: Department of Gynecology A, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors: Eduardo
authors: E
authors: Baptista
authors: Department of Gynecology A, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors: Giselda
authors: G
authors: Carvalho
authors: Department of Gynecology A, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors: Carlos
authors: C
authors: Nobre
authors: Department of Gynecology A, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors: Isabel
authors: I
authors: Dias
authors: Department of Gynecology A, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors: Isabel
authors: I
authors: Torgal
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D020127:Recovery of Function; D012189:Retrospective Studies; D057566:Self Report; D019529:Sexuality; D016896:Treatment Outcome; D014621:Vagina / Q000002:abnormalities* / Q000502:physiology / Q000601:surgery*; D055815:Young Adult