Laparoscopic Cervico Vaginal Reconstruction Using Sigmoid Graft in Patients with Cervicovaginal Agenesis and Functional Uterus: A Case Report for the First Time in the World

Abstract

Introduction:.Various methods have been proposed to treat Cervicovaginal agenesis with the functional uterus, but unfortunately, some of these methods eventually lead to a hysterectomy. In this study, we investigated a new surgical method in treating these patients and its short and long-term consequences, which is performed for the first time in the world by the laparoscopic method.Methods: Seven women aged 18 (12-27) years who had a functional uterus with cervicovaginal agenesis (between 2016 and 1398) in the Ghadir and Dena hospital underwent cervicovaginoplasty with sigmoid colon replacement by laparoscopic method to establish normal menstrual cycles and have a functional uterus and vagina. The average follow-up duration was 25.9 months (2-48 months).Results: The mean BMI of the patients was 19.7 (17.6-22.4). The average time interval between the initiation of disease symptoms and the operation was 52.28 months (2-156 months). All the patients had regular menstrual cycles. The average length of the vagina was 8.9 cm (7.6-10.5 cm). One patient observed proximal stenosis of neovagina 12 months after surgery. We had no significant postoperative complications. We did not perform hysterectomies on our patients. Two subjects had sexual activities without dyspareunia, post-coital bleeding, or malodor vaginal discharge.Conclusion: Sigmoid cervicovaginoplasty is a safe and effective procedure with satisfactory long-term outcomes. This surgery eliminates the psychological burden of hysterectomy in these patients.

Keywords

• mullerian aplasia
• laparoscopy
• vagina abnormalities
• congenital abnormalities