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.