Our Summary

This research paper discusses a case where a new surgical technique was used to treat a rare condition called Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. This condition is characterized by the absence of the vagina from birth and differing levels of uterine development. The surgery, known as a McIndoe modified vaginoplasty, involves creating a new vagina (neovagina) using a graft, which is a piece of tissue taken from another part of the body or from a different species. In this case, the graft came from a pig’s intestinal lining.

The unique aspect of this surgery was the use of a 3D-printed mold to shape the graft. The mold was made from a material called polylactic acid and was customized to fit the patient’s specific body dimensions. The mold was inserted into a space created between the rectum and bladder, where it helped the graft form into the shape of a vagina.

Unfortunately, 13 days after the operation, the patient developed an infection, and the graft detached. Despite this setback, the patient was able to maintain the shape of the new vagina by regularly using a vaginal dilator. After 7 months, the neovagina had achieved a length of 8 cm, was 90% covered in skin cells, and the patient was able to have satisfactory sexual intercourse.

In conclusion, the paper suggests that despite the complications, the use of 3D-printed molds could be a promising approach for surgeries like this in the future. The molds can be tailored to the patient’s individual needs, which could result in better outcomes.

FAQs

  1. What is the Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome?
  2. What is the preferred method of treatment for MRKH syndrome?
  3. How does 3D printing technology facilitate the development of vaginoplasty techniques?

Doctor’s Tip

One helpful tip a doctor might tell a patient about vaginoplasty is to follow the postoperative care instructions closely, including using vaginal dilators as prescribed to maintain the newly created vagina’s shape and function. It is important to communicate any concerns or complications to your healthcare provider promptly for proper management.

Suitable For

Patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, which is the congenital absence of the vagina with variable uterine development, are typically recommended vaginoplasty. In this case, a modified McIndoe vaginoplasty technique with a heterologous graft using a covering customized 3D-printed mold was used for treatment. This technique can be beneficial for patients with MRKH syndrome or other conditions causing vaginal agenesis.

Timeline

Before vaginoplasty:

  1. Diagnosis of MRKH syndrome, a congenital condition characterized by the absence of the vagina and variable uterine development.
  2. Consultation with a healthcare provider to discuss treatment options for vaginoplasty.
  3. Pre-operative assessments and tests to determine suitability for surgery.
  4. Decision to undergo McIndoe vaginoplasty with a heterologous graft using a customized 3D-printed mold.

After vaginoplasty:

  1. Surgery performed using a modified McIndoe technique with porcine intestinal submucosa and a 3D-printed mold.
  2. Post-operative follow-up to monitor healing and complications.
  3. Patient experiences graft infection and total detachment, requiring ongoing use of vaginal dilator.
  4. Despite complications, patient achieves 8 cm vaginal length with 90% epithelialization and satisfactory sexual intercourse after 7 months.
  5. Functional, histological, and anatomical results are achieved, demonstrating the effectiveness of the procedure despite challenges.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with vaginoplasty surgery?
  2. What is the success rate of vaginoplasty in patients with MRKH syndrome?
  3. How long is the recovery period after vaginoplasty surgery?
  4. Will I need to undergo any additional procedures or treatments after vaginoplasty?
  5. How often will I need to dilate the neovagina after surgery?
  6. What are the potential long-term effects of vaginoplasty?
  7. Will I be able to have a normal sex life after vaginoplasty surgery?
  8. Are there any specific lifestyle changes or precautions I should take after vaginoplasty?
  9. What type of follow-up care will I need after vaginoplasty surgery?
  10. How will vaginoplasty surgery impact my overall health and well-being in the long term?

Reference

Authors: Pavan LI, Bourguignon GA, Ubertazzi EP. Journal: Int Urogynecol J. 2021 Aug;32(8):2283-2285. doi: 10.1007/s00192-021-04689-y. Epub 2021 Mar 4. PMID: 33661320