Long-term outcomes of transvestibular vaginoplasty with pelvic peritoneum in 182 patients with Rokitansky's syndrome.

摘要

OBJECTIVE: To evaluate the technical feasibility and anatomical and functional outcomes of one-stage transvestibular vaginoplasty with pelvic peritoneum for the patients with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. DESIGN: A retrospective review of prospectively collected data. SETTING: A university hospital. PATIENT(S): A total of 182 women with MRKH syndrome. INTERVENTION(S): Undergoing transvestibular vaginoplasty with pelvic peritoneum. MAIN OUTCOME MEASURE(S): The perioperative results, complications, and anatomical and functional outcomes of transvestibular vaginoplasty with pelvic peritoneum. RESULT(S): The mean operative time was 72.2 minutes (range 55-150 minutes). Average blood loss was 78.5 mL (range 40-170 mL). The only perioperative complication was one case of rectal-vaginal fistula. Thirty-four patients had vault granulation at the neovagina, which healed after trimming and the mean length of the neovagina was 9 cm (range 7-12 cm) without any shrinkage at the follow-up of 3 months after operation. The neovaginal introitus admitted two fingers in width in all patients. Good functional outcomes were found in the patients at follow-up 15 years after surgery with 80% of the cumulative proportion of sexual satisfactory activity. CONCLUSION(S): Transvestibular vaginoplasty with pelvic peritoneum is an effective and feasible approach for women with MRKH syndrome. The procedure has satisfactory long-term anatomical and functional results.