Abstract:
Objective: To determine the sexual outcomes and motherhood plans of the Mayer Rokitansky Küster Hauser (MRKH) Syndrome patients operated with Uncu Modified Remnant-Supported Laparoscopic Double-Layer Peritoneal Pull-Down Vaginoplasty operation
Design: Cohort Study
Setting: Tertiary University Hospital
Patients: Women with MRKH syndrome
Methods: This study involves the patients with MRKH syndrome who underwent Uncu Modified Remnant-Supported Laparoscopic Double-Layer Peritoneal Pull-Down Vaginoplasty Operation between the years 2008-2020. The first step of the study is about our surgical technique outcomes. The second step consists of long-term results for sexual functioning which was assessed by female sexual function index (FSFI) survey and motherhood plans by another survey.
Main Outcome Measure : FSFI and Motherhood Survey Results
Results Total 42 patients with MRKH syndrome underwent vaginoplasty operation. At least one year after surgery all patients was physically examined. The mean vaginal length was 8.4 + 1.9 cm. The mean FSFI score was 31.5 + 3.9 (min:24-max:36) Thirty-six of the patients answered a survey about motherhood. Thirty-one of the patients (86%) had a desire for motherhood. Most of the patients (21/31 – 68%) choose uterine transplantation as a first option. Three of the patients (9.6%) choose mater option and seven patients (22.5%) wants to be mother by adoption.
Conclusion: Uncu Modified Remnant-Supported Laparoscopic Double-Layer Peritoneal Pull-Down Vaginoplasty Operation is a satisfactory option for patients with MRKH syndrome with high FSFI scores and low complication rates. But creating only a neovagina is not enough for these patients, because of nearly 70% motherhood desire by uterine transplantation.
Key Words : Mullerian Agenesis, Laparoscopy, Neovaginoplasty, Uterine Transplantation, Mayer Rokitansky Küster Hauser Syndrome
Conflict of Interest: The authors report there is no conflict of interest
Funding: None