Total vaginal replacement with sigmoid colon experience at Gaza European hospital

Absence of the vagina in the pediatric population most commonly results from congenital abnormalities. Vaginal replacement may be achieved by several techniques. We review our experience in the efficacy of using a segment of the sigmoid colon for primary vaginal replacement. From 2001 to 2005 we evaluated five patients who required vaginal replacement. In 4 patients the abnormality was suspected because of absent menstruation ,one patient was discovered after marriage at the initial sexual approach .The diagnoses exclusively was Mayer-Rokitansky syndrome. The vagina was reconstructed using a 14 cm isolated sigmoid segment. A minimum of 1 year of follow-up is available .The vagina had a good appearing introitus. Three patients already had an active sexual life[married] all reported to be satisfactory by the husband and wife when asked separately. Stenosis at the mucocutaneous junction in one patient was treated with Y-V plasty. We conclude that our Experience with this group of patients leads us to believe that isolated sigmoid segments provides a cosmetic, self-lubricating neovagina with low rates of failure and revision, and without the need for routine dilation

Total vaginal replacement with sigmoid colon experience at Gaza European hospital

Absence of the vagina in the pediatric population most commonly results from congenital abnormalities.Vaginal replacement may be achieved by several techniques.We reiew our experience in the efficacy of using a segment of the sigmoid colon for primary vaginal replacement. From 2001 to 2005 we evaluated five patients who required vaginal replacement. In 4 patients the abnormality was suspected because of absent menstruation,one patient was discovered after marriage at the initial sexual approach.The diagnoses exclusively was Mayer-Rokitansky syndrome. The vagina was reconstructed using a 14 cm isolated sigmoid segment. A minimum of 1 year of followup is available.The vagina had a good appearing introitus. Three patients already had an active sexual life[married] all reported to be satisfactory by the husband and wife when asked separately.Stenosis at the mucocutaneous junction in one patient was treated withY-V plasty. We conclude that our Experience with this group of patients leads us to believe that isolated sigmoid segments provides a cosmetic, self-lubricating neovagina with low rates of failure and revision, and without the need for routine dilation

Ambiguous genitalia: Diagnosis, evaluation and treatment

The pediatric urologist plays a significant role in the evaluation and the treatment of infant with ambiguous genitalia. On the first day of life, an investigation should be initiated which includes studies, in particular chemical studies that are based on knowledge of enzymatic blockage hormonal studies, karyo-typing and imaging evaluation. Once gender assignment has been made, information regarding the size of the vagina and its position in regard to urogenital sinus become essential to the pediatric urologist when planning a course for reconstruction. Here in we breakdown intersex states into four major categories: female pseudohermaphrodism; male pseudohermaphrodism without mullerian structures; male hermaphrodism with mullerian structures and true hermaphrodism. The role of the pediatric urologist in each of these states is discussed