Functional and anatomic results after creation of a neovagina according to Wharton-Sheares-George in patients with Mayer-Rokitansky-Kuster-Hauser syndrome-long-term follow-up.

摘要

OBJECTIVE: To evaluate the long-term outcomes and degree of satisfaction after neovaginoplasty according to Wharton-Sheares-George in women with Mayer-Rokitansky-Kuster-Hauser syndrome. DESIGN: Open, monocentric follow-up study. SETTING: University hospital and referral center for pediatric and adolescent gynecology. PATIENT(S): Ten patients with Mayer-Rokitansky-Kuster-Hauser syndrome with neovaginas created according to Wharton-Sheares-George 3 to 77 months ago. INTERVENTION(S): Gynecologic follow-up examination, including vaginal swab, bacterial culture, Papanicolaou smear, hybrid capture test for human papillomavirus typing, biopsy, pelvic ultrasound, and 2 questionnaires concerning global quality of life and degree of sexual satisfaction. MAIN OUTCOME MEASURE(S): Satisfaction with sexual function, quality of life, length and width of neovagina, structure of vaginal epithelium, and type of bacterial colonization. RESULT(S): Functional long-term follow-up results showed a high subjective degree of general well-being and sexual satisfaction in affected women. A satisfactory neovaginal length (mean, 8.3 +/- 1.06 cm; range, 7-10 cm) and width (mean, 3.3 +/- 0.5 cm; range, 2.5-4 cm) was obtained. As revealed by smears and biopsy, the neovagina resembled a natural vagina with regard to type of bacterial colonization and structure of epithelium. CONCLUSION(S): The goal of any method of creating a neovagina is to provide the patient the possibility to have satisfactory sexual intercourse and to enhance well-being and quality of life. These aims can be achieved by creating a neovagina according to Wharton-Sheares-George.