Surgical Results for Creation of a Vaginal Canal (Neovagina)
While no surgery is risk free, the risks of the laparoscopic neovagina technique that Dr. Miklos and Moore utilize are very minimal, especially when compared to other surgical techniques to create or lengthen the vagina. Other techniques, including the McIndoe procedure or procedures that utilize a piece of intestine to create the vagina can be much more invasive and carry much higher risks of bowel or bladder injury, infection, bowel obstruction or scarring down of the vaginal canal post-operatively. The Laparoscopic Neovagina approach utilizing peritoneum results in a vaginal canal that has minimal risks of scarring down and has success rates of over 90% a fully functional vagina for intercourse and sexual function including orgasm. During the procedure there is direct visualization of the incision that is made at the top of the vagina into the pelvis (i.e. it is not a blind dissection like the McIndoe) nor are any tissue flaps or grafts required, nor any organs resected (i.e. bowel) to create the vagina. Simply the existing peritoneum is utilized to make a new vagina with a small incision and sutures completed laparoscopically.
Risks such as injury to bowel and bladder always exist however are very minimal risks with this surgery. The ureters (the tubes from the kidneys to the bladder) do run through the pelvis and these are checked closely prior to the end of the surgery to ensure that they were not kinked off by the suture placement. Risks of bleeding is minimal as is risk of post-operative infection. Risk of the vagina scarring down or shortening do also exist, however again with proper post-operative care, proper dilation and pelvic floor therapy, if indicated, this risk is also very minimal.
Surgery is of course only one step for young girls with MRKH and adequate pre-operative counseling should be completed and the patient and her family needs to be mentally ready for surgery and post-operative care, dilation, maintenance etc. Support groups and counseling are available for young women with MRKH and information about the condition, frequently asked questions, how to talk to your teen about the condition and other information can be found at www.MRKH.org