Functional and anatomical results after creation of a neovagina by Davydov` s procedure in patients with Mayer-Rokitansky-Kuster-Hauser syndrome

Abstract

Introduction: Several surgical techniques have been described for the treatment of patients with vaginal agenesis - Mayer-Rokfcansky-Kiister-Hauser (MRKH) syndrome. Aim: To investigate the anatomical and functional outcome of Davydovs procedure in patients with MRKH syndrome. Materials and Methods: A total of 35 patients with MRKH syndrome were operated using the Davydov procedure (peritoneal vaginoplasty) in our unit. Mean age comprised 22.7 ± 0.6 (range - from 17 to 34). The patients then had to use a mould or a vaginal dilatator from 10 POD. Functional results and sexuality were evaluated using the Female Sexual Function Index (FSFI). Results: Three intra-operative rectum and two urinary bladder injuries were repaired without sequelae. Postoperative complications were zero. No patient was lost to follow-up. The anatomical results were considered to be satisfactory (>6 cm) in 31/35 (88.6%) patients: the mean vaginal length was 7.9 ±0.2 cm. According to FSFI: >30 (n=14, 40%), 24-29 (n=18, 51.4%) and <23 (n=3,8.6%). Conclusions: Davydovs procedure may be considered a good option for the surgical treatment of women presenting vaginal agenesis. This technique offers advantages such as: short operating time and hospital stay, functional vaginal length and sexual satisfaction.