A clinical study of modified McIndoe vaginoplasty with split thickness skin graft: a tertiary care experience

ABSTRACT

Background: Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH) is associated with failure of fetal mullerian-duct development that results in congenital deficiency of the upper part of the vagina with a rudimentary-to-absent uterus. These patients have primary amenorrhoea, infertility as well as insufficient sexual gratification. Although conception can be dealt with IVF and surrogacy but at least by doing neovaginal construction by McIndoe vaginoplasty, these patients have acceptable sexual life and intercourse. The main objective of this study was creating a neovagina leading to a satisfactory sexual life.Methods: Modified McIndoe vaginoplasty with split thickness skin graft, was done in seven patients with MRKH syndrome from 2014-2017 and these patients were followed till 2019. All patients had detailed counselling regarding the surgery, the complications involved and the outcome. Thorough investigations were done in all the patients.Results: The functional results were satisfactory in all the seven patients. There was no blood transfusion requirement or any serious complication involved. An average vaginal length of 7-9 cm and vaginal width of 3-4 cm was achieved. Donor site healing was adequate in all patients with no complications.Conclusions: Modified McIndoe vaginoplasty, if performed with good surgical skills, is a secure and beneficial way to achieve sexual contentment in patient with vaginal agenesis, with no donor site complications.