Indigenous technique of fabricating vaginal mould for vaginal reconstruction and uterine drainage in McIndoe vaginoplasty using 10 ml syringe

ABSTRACT

Absence of vagina poses multitude of physical and psychosocial problems in woman's life. 10% of Mayer- Rokitansky-üster-Hauser (MRKH) syndrome patients with high vaginal septum and vaginal atreisa has additional issue of draining uterine cavity. MC Indoe vaginoplasty is universally acceptable and widely practiced procedure for neocolposis reconstruction. Simultaneous reconstruction of vagina with simultaneous continued uterine drainage presents surgical challenge. We offer a simple solution of creating a vaginal mould using a 10 ml disposable syringe, which enables graft application of neovaginal cavity with simultaneous protected uterine drainage per vaginum. Total 10 patients were included in this study of which 4 needed uterine drainage procedure in addition to neovaginal creation. All the patients fared well, there were no problems regarding graft loss or vaginal mould extrusion etc. Fabrication of mould for graft enables easy dressing changes with out disturbing the skin graft. This innovation offers a simple easily reproducible and cheap way of fabricating vaginal mould for McIndoe vaginoplasty. It is especially useful for neovaginal graft application and simultaneous uterine drainage.

KEY WORDS

McIndoe vaginoplasty - syringe vaginal mould - vaginal atresia (Mayer-Rokitansky-Küster-Hauser syndrome)

• REFERENCES

• 1 Bryan AL, Nigro JA, Counseller VS. One hundred cases of congenital absence of the vagina. Surg Gynecol Obstet 1949; 88: 79-86
• 2 Opoku BK, Kwarteng RO. Transverse vaginal septum with menouria and unilateral renal agenesis: A case report. Herbert Open Access J Gynaecol 2015; 3: 1-4
• 3 Nazir Z, Rizvi RM, Qureshi RN, Khan ZS, Khan Z. Congenital vaginal obstructions: Varied presentation and outcome. Pediatr Surg Int 2006; 22: 749-53
• 4 Frank RT. The formation of an artificial vagina without operation. Am J Obstet Gynaecol 1938; 35: 1053-1055
• 5 Rathee M, Boora P, Kundu R. Custom fabricated acrylic vaginal stent as an adjunct to surgical creation of neovagina for a young female with isolated vaginal agenesis. J Hum Reprod Sci 2014; 7: 272-5
• 6 Miller RJ, Breech LL. Surgical correction of vaginal anomalies. Clin Obstet Gynecol 2008; 51: 223-36
• 7 Mcindoe AH, Banister AB. An operation to cure congenital absence of vagia. J Obstet Gynaecol 1938; 45: 490-494
• 8 Fedele L, Frontino G, Motta F, Restelli E, Candiani M. Creation of a neovagina in Rokitansky patients with a pelvic kidney: Comparison of long-term results of the modified Vecchietti and McIndoe techniques. Fertil Steril 2010; 93: 1280-5
• 9 Fritz MA, Speroff L. Clinical Gynaecological Endocrinology and Infertility. Philadelphia –Pennsylvania Lippincott's Williams and Wilkins; 2011
• 10 de Souza AZ, Maluf M, Perin PM, Maluf Filho F, Perin LF. Surgical treatment of congenital uterovaginal agenesis: Mayer-Rokitansky-Küster-Hauser syndrome. Int Surg 1987; 72: 45-7
• 11 Klingele CJ, Gebhart JB, Croak AJ, DiMarco CS, Lesnick TG, Lee RA. McIndoe procedure for vaginal agenesis: Long-term outcome and effect on quality of life. Am J Obstet Gynecol 2003; 189: 1569-72
• 12 Adamson CD, Naik BJ, Lynch DJ. The vacuum expandable condom mold: A simple vaginal stent for McIndoe-style vaginoplasty. Plast Reconstr Surg 2004; 113: 664-6
• 13 Barutçu A, Akgüner M. McIndoe vaginoplasty with the inflatable vaginal stent. Ann Plast Surg 1998; 41: 568-9
• 14 Coskun A, Coban YK, Vardar MA, Dalay AC. The use of a silicone-coated acrylic vaginal stent in McIndoe vaginoplasty and review of the literature concerning silicone-based vaginal stents: A case report. BMC Surg 2007; 7: 13