Laparoscopic peritoneal colpopoiesis using uterine rudiments in a patient with Mayer–Rokitansky–Küster–Hauser syndrome
Background. The progress of medical science has recently contributed to the practical introduction of high-precision methods for the diagnosis and surgical treatment of internal genital malformations in girls. In this connection, there has been a trend of more frequent detection of this pathology, in particular Mayer–Rokitansky–Küster–Hauser syndrome that occurs in 1 in 4,000–5,000 female births; or the incidence of genital malformations in girls is 3–6% of the total number of gynecological diseases. The most socially unfavorable condition is vaginal aplasia that often requires surgical treatment. Various methods are used in this abnormality to form the vagina from an autologous split-thickness skin graft; from the sigmoid colon or the pelvic peritoneum; traction vaginoplasty with introitus tissues.Politova A.K., Kira E.F., Alexandrova A.D., Politova A.A.
Case report. The paper describes a clinical case of laparoscopic peritoneal colpopoiesis modified by L.V. Adamyan. The peculiarity of the described operation was the use of uterine rudiments as a plastic material. It is shown that the use of a rudimentary uterine muscle roller on a cut-out peritoneal flap during laparoscopic peritoneal colpopoiesis in Mayer–Rokitansky–Küster–Hauser syndrome allows one to solve the problem of peritoneal pull-through, tension, and strength in the creation of a neovagina.
Conclusion. Laparoscopic peritoneal colpopoiesis refers to technically complex operations. The latter should be performed by a surgeon who has extensive practical experience and high qualification. The creation of the neovagina using the peritoneum is the most effective and relatively safe method of colpopoiesis with a minimum number of intraoperative and postoperative complications. The technical features of the method of laparoscopic peritoneal colpopoiesis, which are described in this article, enable some problems of the standard procedure to be solved.
Keywords
Mayer–Rokitansky–Küster–Hauser syndrome
peritoneal colpopoiesis
laparoscopy
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Received 27.08.2020
Accepted 13.01.2021
About the Authors
Alla K. Politova, Dr. Med. Sci., Professor, Associate Professor, Professor of the Department of Women's Diseases and Reproductive Health of the Institute for the Improvement of Doctors, N.I. Pirogov National Medical and Surgical Center, Ministry of Health of Russia; Head of the Center for Women's Health, N.I. PirogovNational Medical and Surgical Center, Ministry of Health of Russia. Tel. : +7(926)605-38-14. E-mail: al1870@mail.ru.
105203, Russia, Moscow, Nizhnyaya Pervomayskaya str., 70.
Eugene F. Kira, Honored Scientist of the Russian Federation, Honored Doctor of the Russian Federation, Dr. Med. Sci., Professor, Head of the Department of Women 's Diseases and Reproductive Health of the Institute of Medical Improvement, N.I. Pirogov National Medical and Surgical Center, Ministry of Health of Russia.
Tel. : +7(916)576- 54-32. E-mail: profkira33@gmail.com. 105203, Russia, Moscow, Nizhnyaya Pervomayskaya str., 70.
Anastasia D. Alexandrova, Resident of the Gynecology Department of the Center for Women's Health, N.I. Pirogov National Medical and Surgical Center,
Ministry of Health of Russia. Tel. : +7(916)554-92-96. 105203, Russia, Moscow, Nizhnyaya Pervomayskaya str., 70.
Alexandra A. Politova, student, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University). Tel. : +7(915)123-38-44.
E-mail: alexandra.politowa@mail.ru. 119991, Russia, Moscow, Trubetskaya str., 8-2.
For citation: Politova A.K., Kira E.F., Alexandrova A.D., Politova A.A. Laparoscopic peritoneal colpopoiesis using uterine rudiments in a patient with Mayer–Rokitansky–Küster–Hauser syndrome.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 3: 196-200 (in Russian)
https://dx.doi.org/10.18565/aig.2021.3.196-200
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