Modern approaches to the treatment of patients with aplasia of the uterus and vagina by the method of peritoneal colpopoiesis

Adamyan L.V.

Moscow State Medical and Dental University named after A.I. Evdokimov

SPIN RSCI: 9836-2713
Scopus AuthorID: 7006372422
ResearcherID: Q-1722-2018
ORCID: 0000-0002-3253-4512

Arakelyan A.S.

National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov of the Ministry of Healthcare of Russia

Popryadukhin A.Yu.

Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology

Modern approaches to the treatment of patients with aplasia of the uterus and vagina by the method of peritoneal colpopoiesis

Authors:

Adamyan L.V., Arakelyan A.S., Popryadukhin A.Yu.

More about the authors

Journal: Russian Bulletin of Obstetrician-Gynecologist. 2021;21(4): 81‑87

DOI: 10.17116/rosakush20212104181

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To cite this article:

Adamyan LV, Arakelyan AS, Popryadukhin AYu. Modern approaches to the treatment of patients with aplasia of the uterus and vagina by the method of peritoneal colpopoiesis. Russian Bulletin of Obstetrician-Gynecologist. 2021;21(4):81‑87. (In Russ.)
https://doi.org/10.17116/rosakush20212104181

Подписка 2025-2 (Russian Bulletin of Obstetrician-Gynecologist)

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OBJECTIVE

Optimization of surgical treatment of patients with uterine and vaginal aplasia.

MATERIAL AND METHODS

The study was conducted on a cohort of patients admitted to the Federal State Budgetary Institution «National Medical Research Center for Obstetrics, Gynecology and Perinatology named after academician V.I. Kulakov» for surgical treatment of aplasia of the uterus and vagina in the period from 2012 to 2020.

RESULTS

Examined and treated 161 women with aplasia of the uterus and vagina; 134 (83.2%) underwent laparoscopic colpopoiesis from the pelvic peritoneum. The average age at the time of treatment was 25.7±6.9 years. All patients underwent a complete anamnesis collection, gynecological examination, as well as instrumental studies to confirm the main diagnosis and concomitant genital/extra-genital pathology. All patients had satisfactory postoperative results, namely the appropriate depth (length) and width of the vagina, as well as the ability to have sexual intercourse.

CONCLUSION

Various modern modifications of the neovagina creation are the operation of choice for the correction of uterine and vaginal aplasia. The technique modified by L.V. Adamyan is based on the creation of a neovagina with adequate size for the coitus execution. Surgical intervention is fast, effective; it gives a very low incidence of intra-, postoperative and long-term complications, and also it provides satisfactory long-term results.

Keywords:

Mayer—Rokitansky—Kuester—Hauser syndrome (MRKHS)

aplasia of the uterus and vagina

neovagina

colpopoiesis

Authors:

Adamyan L.V.

Moscow State Medical and Dental University named after A.I. Evdokimov

SPIN RSCI: 9836-2713
Scopus AuthorID: 7006372422
ResearcherID: Q-1722-2018
ORCID: 0000-0002-3253-4512

Arakelyan A.S.

National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov of the Ministry of Healthcare of Russia

Popryadukhin A.Yu.

Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology

Received:

03.06.2021

Accepted:

19.06.2021

List of references:

Arakelyan AS, Popryadukhin AYu, Karapetyan EA. Genetic factors in the development of the Mayer—Rokitansky—Küster—Hauser syndrome (aplasia of the uterus and vagina). Problemy Reproduktsii. 2020;26:5:43-50. (In Russ.). https://doi.org/10.17116/repro20202605143
Oppelt P, Renner SP, Brucker S, Strissel PL, Strick R, Oppelt PG, Doerr HG, Schott GE, Hucke J, Wallwiener D, Beckmann MW. The VCUAM (Vagina Cervix Uterus Adnex- associated Malformation) classification: a new classification for genital malformations. Fertil Steril. 2005;84:1493-1497.
Oppelt PG, Lermann J, Strick R, Dittrich R, Strissel P, Rettig I, Schulze C, Renner SP, Beckmann MW, Brucker S, Rall K, Mueller A. Malformations in a cohort of 284 women with Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH). Reprod Biol Endocrinol. 2012;10:57. https://doi.org/10.1186/1477-7827-10-57
Carlomagno G, Di Blasi A, Monica MD. Congenital scoliosis associated with agenesis of the uterine cervix. Case report. BMC Womens Health. 2004;4:4.
Strubbe EH, Cremers CW, Dikkers FG, Willemsen WN. Hearing loss and the Mayer—Rokitansky—Kuster—Hauser syndrome. Am J Otol. 1994;15:431-436.
Pizzo, A, Laganà AS, Sturlese E, Retto G, Retto A, De Dominici R, Puzzolo D. Mayer—Rokitansky—Kuster—Hauser syndrome: embryology, genetics and clinical and surgical treatment. ISRN Obstet Gynecol. 2013;2013:628717. https://doi.org/10.1155/2013/628717
Herlin M, Højland AT, Petersen MB. Familial occurrence of Mayer—Rokitansky—Kuster—Hauser syndrome: a case report and review of the literature. Am J Med Genet. 2014;164A:2276-2286.
Oppelt P, von Have M, Paulsen M, Strissel PL, Strick R, Brucker S, Wallwiener D, Beckmann MW. Female genital malformations and their associated abnormalities. Fertil Steril. 2007;87:2:335-342. https://doi.org/10.1016/j.fertnstert.2006.07.1501
Guerrier D, Mouchel T, Pasquier L, Pellerin I. The Mayer—Rokitansky—Kuster—Hauser syndrome (congenital absence of uterus and vagina)—phenotypic manifestations and genetic approaches. J Negat Results Biomed. 2006;5:1:1. https://doi.org/10.1186/1477-5751-5-1
Weijenborg PT, ter Kuile MM. The effect of a group programme on women with the Mayer—Rokitansky—Kuster—Hauser syndrome. BJOG. 2000;107:365-368.
Lermann J, Mueller A, Wiesinger E, Häberle L, Brucker S, Wallwiener D, Dittrich R, Renner SP, Beckmann MW, Oppelt PG. Comparison of different diagnostic procedures for the staging of malformations associated with Mayer—Rokitansky—Kuster—Hauser syndrome. Fertil Steril. 2011;96:1:156-159. https://doi.org/10.1016/j.fertnstert.2011.04.051
Brun JL, Belleanne ́e G, Grafeille N, Aslan AF, Brun GH. Long-term results after neovagina creation in Mayer—Rokitansky—Kuster—Hauser syndrome by Vecchietti’s operation. Eur J Obstet Gynaecol Reprod Biol. 2002;103:168-172.
Banister JB, McIndoe AH. Congenital absence of the vagina, treated by means of an indwelling skin-graft. Proc R Soc Med. 1938;31:105-1056.
Baldwin J. Formation of an artificial vagina by intestinal transplantation. Ann Surg. 1904;40:398-403.
Davydov S. Colpopoiesis from the peritoneum of the uterorectal space. Obstet Gynecol. 1969;12:255-257.
Williams EA. Congenital absence of the vagina: a simple operation for its relief. J Obstet Gynaecol Br Commonw. 1964;71:511-512.
Vecchietti G. Neovagina nella sindrome di Rokitansky—Kuster—Hauser [Neovagina in Mayer—Rokitansky—Kuster—Hauser syndrome]. Attual Obstet Ginecol. 1965;11:131-147.
Frank R. The formation of an artificial vagina without operation. Am J Obstet Gynecol. 1938;35:1053-1055.
Uvarova EV, Davtyan GM, Buralkina NA, Kruglyak DA. Vagina formation by a complex non-surgical colpopoiesis in patients with Mayer—Rokitansky—Kuster—Hauser syndrome. Reproduktivnoe zdorov’e detei i podrostkov. 2014;59:6:40-49. (In Russ.).
Ingram JM. The bicycle seat stool in the treatment of vaginal agenesis and stenosis: a preliminary report. Am J Obstet Gynecol. 1981;140:867-873.
D’Alberton A, Santi F. Formation of a neovagina by coitus. Obstet Gynecol. 1972;40:763-764.
ACOG Committee on Adolescent Health Care. ACOG committee opinion. Number 274, July 2002. Nonsurgical diagnosis and management of vaginal agenesis. Obstet Gynecol. 2002;100:213-216.
Adamyan L. Additional international perspectives. In: Nichols D.H., ed. Gynecologic and Obstetric Surgery. St. Louis: Mosby Year Book. 1993;1167-1182.
Adamyan LV, Kulakov VI, Hashukoeva AZ. Malformations of the uterus and vagina. M.: Meditsina. 1998. (In Russ.).
Selezneva ND. Modern principles of reconstructive surgery in gynecology. M. 1984;4-5. (In Russ.).
Hensle TW, Chang DT. Vaginal reconstruction. Urol Clin North Am. 1999;26:39-47.
Tamaya T, Fujimoto J. Comparison between transabdominal-vulvar and transvulvar approaches for peritoneal vaginoplasty in patients with congenital absence of the vagina. Eur J Obstet Gynecol Reprod Biol. 1997;72:79-81.
Zhou JH, Sun J, Yang CB, Xie ZW, Shao WQ, Jin HM. Long-term outcomes of transvestibular vaginoplasty with pelvic peritoneum in 182 patients with Rokitansky’s syndrome. Fertil Steril. 2010;94:2281-2285.
2585739. Russian Federation, IPC A61B 17/42 (2006.01) A61B 17/94 (2006.01) Patentee: Federal State Budgetary Institution «Scientific Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov» of the Ministry of Health of the Russian Federation (RU). Authors: Bobkova Marina Viktorovna (RU), Adamyan Leila Vagoevna (RU), Arakelyan Alek Seiranovich (RU), Khoroshun Nikolai Dmitrievich (RU), Makiyan Zograb Nikolaevich (RU). Application: 2015119396/14, 05/25/2015. Published: 10.06.16. Bul. No. 16. (In Russ.).
2587723 Russian Federation, IPC A61B 17/42 (2006.01). Patentee: Federal State Budgetary Institution «Scientific Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov» of the Ministry of Health of the Russian Federation (RU). Authors: Adamyan Leila Vagoevna (RU), Bobkova Marina Viktorovna (RU), Sipchenko Dmitrii Andreevich (MD). Application: 2015126640/14, 03.07.2015. Published: 20.06.2016 Bul. No. 17. (In Russ.).
Bianchi S, Frontino G, Ciappina N, Restelli E, Fedele L. Creation of a neovagina in Rokitansky syndrome: comparison between two laparoscopic techniques. Fertil Steril. 2011;95:1098-1100.
Schonbucher V, Schweizer K, Richter-Applet H. Sexual quality of life in individuals with disorders of sex development and a 46,XY karyo- type: a review of international research. J Sex Marital Ther. 2010;36:193-215.

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