Surgical and non-surgical methods of creation of a neovagina in patients with Mayer–Rokitansky–Kuster–Hauser syndrome: a systematic review

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

To study the effectiveness of surgical and non-surgical methods of vaginoplasty in patients with Mayer–Rokitansky–Kuster–Hauser syndrome by comparing themselves. This systematic review includes all publications in English about studies that which compare non-surgical vaginoplasty methods with surgical ones and surgical methods between themselves for the period 1975–2023. The review is written according to the PRISMA checklist. Randomized and non-randomized original clinical trials (comparative retrospective, randomized controlled, retrospective, etc.) were used for the analysis. After searching for and eliminating duplicates, 780 articles were screened, 739 of which were excluded for mismatching titles and abstracts. As a result, 23 studies were selected for qualitative synthesis. Taking into account the experience of clinical use and scientific and practical data, it can be noted the first-choice treatment should begin with non-surgical methods, but besides them, there are many options for surgical vaginoplasty methods using intestinal segments, a segment of the peritoneum, amnion, skin grafts, autologous vaginal tissue cultured in vitro, etc. Thus, there is a need for more randomized controlled trials comparing various methods of creating a neovagina in patients with Mayer–Rokitansky–Kuster–Hauser syndrome.

Full Text

Restricted Access

About the authors

Elena V. Sibirskaya

N.I. Pirogov Russian National Research Medical University (Pirogov Medical University); Russian University of Medicine

Author for correspondence.
Email: elsibirskaya@yandex.ru
ORCID iD: 0000-0002-4540-6341
SPIN-code: 1356-9252

MD, PhD, Professor, Russian Children’s Clinical Hospital

Russian Federation, Moscow; Moscow

Irina V. Karachentsova

N.I. Pirogov Russian National Research Medical University (Pirogov Medical University)

Email: elsibirskaya@yandex.ru
ORCID iD: 0000-0002-0254-690X
SPIN-code: 6520-9747

MD, PhD, Assistant Professor, Russian Children’s Clinical Hospital

Russian Federation, Moscow

Polina O. Nikiforova

N.I. Pirogov Russian National Research Medical University (Pirogov Medical University)

Email: pol_nikiforova@mail.ru
ORCID iD: 0000-0001-5046-9016
SPIN-code: 7120-3165

MD, Russian Children’s Clinical Hospital

Russian Federation, Moscow

Alena A. Kovaleva

N.I. Pirogov Russian National Research Medical University (Pirogov Medical University)

Email: A9671133340@yandex.ru
ORCID iD: 0009-0006-0088-3650
SPIN-code: 8883-1090

Student

Russian Federation, Moscow

Ulyana E. Romanikova

N.I. Pirogov Russian National Research Medical University (Pirogov Medical University)

Email: romanikova@icloud.com
ORCID iD: 0009-0001-2005-0975

Student

Russian Federation, Moscow

Asiyat D. Lepshokova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: lepsokovaasiat46@gmail.com
ORCID iD: 0009-0001-0483-7655

Student

Russian Federation, Moscow

References

  1. Herlin MK. Genetics of Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome: advancements and implications. Front Endocrinol (Lausanne). 2024;15:1368990. doi: https://doi.org/10.3389/fendo.2024.1368990
  2. Chmel R, Pastor Z, Novackova M, et al. Methods for neovagina creation in women with Mayer–Rokitansky–Küster–Hauser syndrome for subsequent uterus transplantation. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2021;165(4):360–366. doi: https://doi.org/10.5507/bp.2021.049
  3. Patnaik SS, Brazile B, Dandolu V, et al. Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome: a historical perspective. Gene. 2015;555(1):33–40. doi: https://doi.org/10.1016/j.gene.2014.09.045
  4. Liszewska-Kapłon M, Strózik M, Kotarski Ł, et al. Mayer–Rokitansky–Küster–Hauser syndrome as an interdisciplinary problem. Adv Clin Exp Med. 2020;29(4):505–511. doi: https://doi.org/10.17219/acem/118850
  5. Lee MH. Non-surgical treatment of vaginal agenesis using a simplified version of Ingram’s method. Yonsei Med J. 2006;47(6):892–895. doi: https://doi.org/10.3349/ymj.2006.47.6.892
  6. Адамян Р.Т., Блбулян А.К., Абрамян Р.А., и др. Синдром Майера–Рокитанского–Кюстера–Хаузера // Акушерство, гинекология и репродукция. — 2023. — Т. 17. — № 5. — С. 654–662. [Adamyan RT, Blbulyan AK, Abrahamyan RA, et al. Mayer–Rokitansky–Küster–Hauser syndrome. Akusherstvo, Ginekologia i Reprodukcia = Obstetrics, Gynecology and Reproduction. 2023;17(5):654–662. (In Russ.)] doi: https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.419
  7. Моргошия Т.Ш. Научное наследие Гийома Дюпюитрена (1777–1835) // Оперативная хирургия и клиническая анатомия (Пироговский научный журнал). — 2019. — Т. 3. — № 1. — С. 52–56. [Morgoshia TSh. Scientific heritage of Guillaume Dupuytren (1777–1835). Russian Journal of Operative Surgery and Clinical Anatomy. 2019;3(1):52–56. (In Russ.)]
  8. Сибирская Е.В., Караченцова И.В., Панасенко Т.С. Синдром Майера–Рокитанского–Кюстера–Хаузера // Эффективная фармакотерапия. — 2022. — Т. 18. — № 24. — С. 38–42. [Sibirskaya EV, Karachencova IV, Panasenko TS. Mayer–Rokitansky–Küster–Hauser syndrome. Effektivnaya farmakoterapiya. 2022;18(24):38–42. (In Russ.)] doi: https://doi.org/10.33978/2307-3586-2022-18-24-38-42
  9. Zhong CX, Wu JX, Liang JX, et al. Laparoscopic and gasless laparoscopic sigmoid colon vaginoplasty in women with vaginal agenesis. Chin Med J (Engl). 2012;125(2):203–208. doi: https://doi.org/10.3760/cma.j.issn.0366-6999.2012.02.008
  10. Pizzo A, Laganà AS, Sturlese E, et al. Mayer–Rokitansky–Küster–Hauser syndrome: embryology, genetics and clinical and surgical treatment. ISRN Obstet Gynecol. 2013;2013:628717. doi: https://doi.org/10.1155/2013/628717
  11. Baldwin JF. XIV. The Formation of an Artificial Vagina by Intestinal Trransplantation. Ann Surg. 1904;40(3):398–403.
  12. Chakrabarty S, Mukhopadhyay P, Mukherjee G. Sheares’ method of vaginoplasty — our experience. J Cutan Aesthet Surg. 2011;4(2):118–121. doi: https://doi.org/10.4103/0974-2077.85032
  13. Higgins JPT, Thomas J, Chandler J, et al. (eds). Cochrane Handbook for Systematic Reviews of In terventions. Version 6.1 (updated September 2020). Cochrane; 2020. Available from: https://www.training.cochrane.org/handbook (accessed: 08.02.2023).
  14. Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898. doi: https://doi.org/10.1136/bmj.l4898
  15. Sterne JAC, Higgins JPT. Reeves BC on behalf of the development group for ACROBAT-NRSI. A Cochrane Risk Of Bias Assessment Tool: for Non-Randomized Studies of Interventions (ACROBAT NRSI). Version 1.0.0, 24 September 2014. Available from: https://www.bristol.ac.uk/population-health-sciences/centres/ cresyda/barr/riskofbias/robins-i/acrobat-nrsi/ (accessed: 08.02.2023).
  16. Ding JX, Chen LM, Zhang XY, et al. Sexual and functional outcomes of vaginoplasty using acellular porcine small intestinal submucosa graft or laparoscopic peritoneal vaginoplasty: a comparative study. Hum Reprod. 2015;30(3):581–589. doi: https://doi.org/10.1093/humrep/deu341
  17. Cheikhelard A, Bidet M, Baptiste A, et al. Surgery is not superior to dilation for the management of vaginal agenesis in Mayer–Rokitansky–Küster–Hauser syndrome: a multicenter comparative observational study in 131 patients. Am J Obstet Gynecol. 2018;219(3):281.e1–281.e9. doi: https://doi.org/10.1016/j.ajog.2018.07.015
  18. Morcel K, Lavoué V, Jaffre F, et al. Sexual and functional results after creation of a neovagina in women with Mayer–Rokitansky–Küster–Hauser syndrome: a comparison of nonsurgical and surgical procedures. Eur J Obstet Gynecol Reprod Biol. 2013;169(2):317–320. doi: https://doi.org/10.1016/j.ejogrb.2013.03.005
  19. Pennesi CM, English EM, Bell S, et al. Prevalence of urinary, prolapse, and bowel symptoms in Mayer–Rokitansky–Küster–Hauser syndrome. Am J Obstet Gynecol. 2021;225(1):70.e1–70.e12. doi: https://doi.org/10.1016/j.ajog.2021.02.020
  20. Herlin M, Bay Bjørn AM, Jørgensen LK, et al. Treatment of vaginal agenesis in Mayer–Rokitansky–Küster–Hauser syndrome in Denmark: a nationwide comparative study of anatomical outcome and complications. Fertil Steril. 2018;110(4):746–753. doi: https://doi.org/10.1016/j.fertnstert.2018.05.015
  21. Willemsen WN, Kluivers KB. Long-term results of vaginal construction with the use of Frank dilation and a peritoneal graft (Davydov procedure) in patients with Mayer–Rokitansky–Küster syndrome. Fertil Steril. 2015;103(1):220–7.e1. doi: https://doi.org/10.1016/j.fertnstert.2014.10.014
  22. Sysak R, Bluska P, Stencl P, et al. Agenesis of female internal reproductive organs, the Mayer–Rokitansky–Küster–Hauser syndrome. Bratisl Lek Listy. 2021;122(12):839–845. doi: https://doi.org/10.4149/BLL_2021_136
  23. Hayashida SA, Soares JM Jr, Costa EM, et al. The clinical, structural, and biological features of neovaginas: a comparison of the Frank and the McIndoe techniques. Eur J Obstet Gynecol Reprod Biol. 2015;186:12–16. doi: https://doi.org/10.1016/j.ejogrb.2014.12.025
  24. Jasonni VM, La Marca A, Naldi S, et al. The management of vaginal agenesis: report of 104 cases. Fertil Steril. 2007;88(6):1653–1656. doi: https://doi.org/10.1016/j.fertnstert.2007.01.126
  25. Yang X, Zhu L, Wang YJ, et al. Comparison of the modified laparoscopic Vecchietti and Davydov colpoplasty techniques in Mayer–Rokitansky–Küster–Hauser syndrome: A long-term follow-up analysis. J Obstet Gynaecol Res. 2022;48(7):1930–1937. doi: https://doi.org/10.1111/jog.15262
  26. Zhao X, Zhang Y, Zhang M, et al. Comparison of two laparoscopic vaginoplasties using a single peritoneal flap in patients with Mayer–Rokitansky–Küster–Hauser syndrome. Int Urogynecol J. 2022; 33(9):2543–2549. doi: https://doi.org/10.1007/s00192-021-04921-9
  27. Fedele L, Frontino G, Motta F, et al. Creation of a neovagina in Rokitansky patients with a pelvic kidney: comparison of long-term results of the modified Vecchietti and McIndoe techniques. Fertil Steril. 2010;93(4):1280–1285. doi: https://doi.org/10.1016/j.fertnstert.2008.12.020
  28. Wright C, Hanna MK. Thirty-six vaginal constructions: lessons learned. J Pediatr Urol. 2014;10(4):667–671. doi: https://doi.org/10.1016/j.jpurol.2014.04.007
  29. Cao L, Wang Y, Li Y, et al. Prospective randomized comparison of laparoscopic peritoneal vaginoplasty with laparoscopic sigmoid vaginoplasty for treating congenital vaginal agenesis. Int Urogynecol J. 2013;24(7):1173–1179. doi: https://doi.org/10.1007/s00192-012-1991-9
  30. Feroze RM, Dewhurst CJ, Welply G. Vaginoplasty at the Chelsea hospital for women: a comparison of two techniques. Br J Obstet Gynaecol. 1975;82(7):536–540. doi: https://doi.org/10.1111/j.1471-0528.1975.tb00683.x
  31. Deldar-Pesikhani M, Ghanbari Z, Shahrbabaki FS, et al. Comparison of modified McIndoe and Davydov vaginoplasty in patients with MRKH syndrome in terms of anatomical results, sexual performance and satisfaction. J Family Med Prim Care. 2022;11(8):4614–4618. doi: https://doi.org/10.4103/jfmpc.jfmpc_1939_21
  32. Xu H, Hou S, Ruan Z, et al. Comparing Anatomical and Functional Outcomes of Two Neovaginoplasty Techniques for Mayer–Rokitansky–Küster–Hauser Syndrome: A Ten-Year Retrospective Study with Swine Small Intestinal Submucosa and Homologous Skin Grafts. Ther Clin Risk Manag. 2023;19:557–565. doi: https://doi.org/10.2147/TCRM.S415672
  33. Bianchi S, Frontino G, Ciappina N, et al. Creation of a neovagina in Rokitansky syndrome: comparison between two laparoscopic techniques. Fertil Steril. 2011;95(3):1098–100.e1–3. doi: https://doi.org/10.1016/j.fertnstert.2010.11.032
  34. Borruto F, Chasen ST, Chervenak FA, et al. The Vecchietti procedure for surgical treatment of vaginal agenesis: comparison of laparoscopy and laparotomy. Int J Gynaecol Obstet. 1999;64(2):153–158. doi: https://doi.org/10.1016/s0020-7292(98)00244-6
  35. Tamaya T, Fujimoto J. Comparison between transabdominal-vulvar and transvulvar approaches for peritoneal vaginoplasty in patients with congenital absence of the vagina. Eur J Obstet Gynecol Reprod Biol. 1997;72(1):79–81. doi: https://doi.org/10.1016/s0301-2115(96)02665-6
  36. Bhalerao AV, Mehta J, Dixit P, et al. Comparative study of creation of neovagina using skin graft and Interceed in Mayer–Rokitansky–Küster–Hauser syndrome. J of SAFOG. 2022;14(3):233–237. doi: https://doi.org/10.5005/jp-journals-10006-2056
  37. Wu J, Guo R, Chu D, et al. Comparison of Two Techniques of Laparoscopy-Assisted Peritoneal Vaginoplasty. J Minim Invasive Gynecol. 2016;23(3):346–351. doi: https://doi.org/10.1016/j.jmig.2015.10.015
  38. McGuinness LA, Higgins JPT. Risk-of-bias VISualization (robvis): An R package and Shiny web app for visualizing risk-of-bias assessments. Res Synth Methods. 2021;12(1):55–61. doi: https://doi.org/10.1002/jrsm.1411

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. PRISMA Flow diagram

Download (443KB)
Indexing metadata
3. Fig. 2. RoB 2 for randomized trials

Download (131KB)
Indexing metadata
4. Fig. 3. ROBINS-I for non-randomized studies

Download (460KB)
Indexing metadata

Copyright (c) 2026 "Paediatrician" Publishers LLC



Этот сайт использует файлы cookie и сервис сбора персональных данных (Яндекс.Метрика), чтобы анализировать трафик, а также улучшать работу сайта. Нажимая кнопку «Я согласен/согласна», вы даете согласие на обработку ваших данных. Подробности — в нашей Политике конфиденциальности.