Introduction
Since Mayer-Rokitansky-Küster-Hauser syndrome was first described1, numerous vaginoplasty methods have been invented. ACOG (American College of Obstetrics and Gynecology) advises vaginal non-surgical, self-dilatation method as first-line treatment in MRKH patients.2 Nevertheless, in some cases, anatomic and sexual results are not satisfactory. Patients may not be capable of sexual intercourse with self-dilatation. Also, this method requires long-term exercises and patient compliance. Thus, surgical options may be helpful for patient satisfaction. There are mainly three surgical methods for neovagina creation. The first approach is the Mc Indoe method3, a vaginal surgery consisting of insertion a created vagina (with numerous materials like an autologous skin graft, invitro cultured vaginal tissue, acellular collagen, amniotic membrane, fish skin, buccal mucosa) into the dissected pouch between rectum and bladder.4-11 The second approach is the Vechietti operation which requires long-term abdomen-vaginal traction with special instruments.12-14 This method is including both vaginal and abdominal (laparotomy or laparoscopy) surgery. The last method is Davydov vaginoplasty. In this technique, a canal is created between the blind vaginal introitus and the peritoneal cavity by dissection. The parietal peritoneum is pulled down by vaginal approach, and the vaginal cuff is closed with purse-string sutures.15 With our previously described Uncu Modified Remnant-Supported Laparoscopic Double-Layer Peritoneal Pull-Down Vaginoplasty Operation, we perform all surgical steps laparoscopically, and we are supporting the vaginal cuff with paramesonephric remnants by second layer suturation.16 There have been over ten years since our first case, and we noticed that patients operated by our technique are in a desire for motherhood. There are seventeen published live births by uterine transplantation17 and numerous live births by maternal surrogacy from different countries globally for MRKH patients. Also, child adoption is an option for these patients.
In this survey study, we aimed to show the current anatomic and sexual results of our operated cases with MRKH and discuss motherhood options with survey results.