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    Intestinal vaginoplasty: seven years' experience of a tertiary center
    (ELSEVIER SCIENCE INC, 2010) Karateke, Ates; Haliloglu, Berna; Parlak, Onur; Cam, Cetin; Coksuer, Hakan
    Objective: To investigate the long-term effects of intestinal vaginoplasty in cases with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. Design: Prospective study. Setting: Division of Pelvic Reconstructive Surgery, Department of Gynecology and Obstetrics, at a women's and children disease education and research hospital. Patient(s): Between 2003 and 2009, 29 patients with MRKH syndrome underwent intestinal vaginoplasty. Intervention(s): Two of the patients were treated with ileal and 27 with sigmoid vaginoplasty. Main Outcome Measure(s): The age, marital status, associated anomalies, method used for bowel transposition (isoperistaltic/antiperistaltic), type of abdominal incision, and intra-and postoperative complications were evaluated. Result(s): One of the patients for whom ileal vaginoplasty was performed had 40 cm ileal necrosis requiring bilateral ileostomy for 2 months. Introital stenosis was detected in 15 cases (79%) who were unmarried, while none of the married cases had introital stenosis. However, all patients responded to finger-dilatation. All married patients were sexually satisfied after operation. An intraluminal abscess developed in the proximal segment of the neovagina owing to stricture occurring above abdominoperineal tunnel 2 years after operation. In another patient who had a rudimentary uterine horn, hematometra developed 3 years after operation and treated with resection. Conclusion(s): In our experience, sigmoid vaginoplasty seems to be a favorable procedure which provides excellent long-term results for the patients with vaginal agenesis. (Fertil Steril (R) 2010;94:2312-5. (C) 2010 by American Society for Reproductive Medicine.)

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