Neovagina creation with the use of the pelvic peritoneum

Abstract

Aim: to present the technique of neo-vagina formation with the use of pelvic peritoneum for the treatment of women with vaginal agenesis; to review the data focusing on the postoperative functional results; and to analyze its potential advantages and limitations.Brief description of the review data: Laparoscopic- assisted peritoneal colpopoesis has proven to be reliable and effective method of neovagina creation associated with minimal morbidity and excellent functional and anatomical results. It can be successfully used in patients with vaginal agenesis with or without rudimentary uteri and in patients with previously unsuccessful treatments. Our original experience since 1992 involves 324 patients who underwent this surgery. Long-term evaluation in patients operated on between 1995 and 2013 identified an 87.8 % satisfaction rate as compared with 76 % satisfaction rate in the control group and indicated a functional vaginal length of 12.46 - 1.16 cm with anatomical vaginal length of 10.87 - 1.0 cm, and a minimal complications rate. Clinical Implication: Multiple successful methods of neovagina creation are currently used. The pearls for minimizing complications and providing maximal results for the surgeon employing a laparoscopic-assisted peritoneal colpopoesis technique are described in this chapter.Open issues for further research: While technical and methodological advancements for neo-vagina formation continue to develop, research that further identifies etiologic factors in the development of vaginal agenesis, studies related to concomitant pathology in the patients, and investigations into the use of cellular technologies for the formation of the cervical canal in women with functional uteri with vaginal and cervical aplasia would be of a significant importance. Special considerations related to endometriosis in women with mullerian anomalies need further investigation as well.