Functional and anatomic results of amnion vaginoplasty in young women with Mayer-Rokitansky-Küster-Hauser syndrome

ObjectiveTo evaluate the surgical outcome and the long-term anatomic and functional results in young women with Mayer-Rokitansky-Küster-Hauser Syndrome (MRKH) undergoing neovaginal creation with amniotic membranes.DesignEvaluation of surgical and functional outcome according to clinical records and validated questionnaires about sexuality (Female Sexual Function Index [FSFI]) over a 1.5-year follow-up period.SettingUniversity hospital and referral center for pediatric and adolescent gynecology.Patient(s)Seven patients with congenital vaginal aplasia with a mean age of 20.86 ± 3.56 years (range 17–26 years).Intervention(s)McIndoe procedure modified by the application of human freeze-dried amniotic membranes.Main Outcome Measure(s)Anatomic success was defined by a vaginal length ≥8 cm, and a width allowing the easy introduction of two fingers. FSFI scores were applied to define functional results.Result(s)Mean neovaginal length was 9.3 cm (range 4–12 cm). The mean FSFI score was 30.0 ± 6.9. Major operative complications occurred in one patient. In six out of seven patients satisfactory anatomic and functional results were achieved.Conclusion(s)The surgical dissection of the vesicorectal space and the application of human amnion over a vaginal mold to create a neovagina results in satisfying anatomic and functional outcome with low perioperative morbidity in MRKH patients.