Experience with specially designed pored polyacetal mold dressing method used in McIndoe-style vaginoplasty

Autologous Oral Mucosal Mesh Graft for Vaginoplasty: Seven Tips in the Techniques

The demand for sexual life makes vaginoplasty a crucial need for patients who had complete vagina agenesis. We present our experience on vaginoplasty by using a maximum amount of meshing oral mucosal grafts in a case series study on 43 patients. The patients were followed up for an average of 19 months, ranging from 6 months to 4 years. No serious complications were reported. The patients gained good results also at neovagina and donor sites. These results were proved on clinical, endoscopy images, and biopsies. We recommend seven tips in the techniques to be used to achieve these significant results.

Vaginoplasty: modified McIndoe using xenograft and a tailored 3D-printer mold

INTRODUCTION AND HYPOTHESIS

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is the congenital absence of the vagina with variable uterine development. Different methods have been reported for vaginoplasty treatment. The preferred vaginal approach to treating this condition is usually McIndoe vaginoplasty supported by regular dilatation of the neovagina. We present a case video of a McIndoe modified vaginoplasty technique with a heterologous graft using a covering customized 3D-printed mold, its postoperative follow-up and postoperative complications.

METHODS

Video presentation of a McIndoe modified vaginoplasty technique using porcine intestinal submucosa performed in a 18-year-old woman diagnosed with MRKH syndrome. Different sizes of a polylactic acid mold were manufactured with 3D printers. After dissection of the recto-vesical space, a mold tailored in terms of length and width was chosen for this patient.

RESULTS

After 13 days of follow-up, the patient presented graft infection and subsequent total graft detachment. However, the patient continued to use the vaginal dilator permanently. After 7 months, 8 cm vaginal length with 90% epithelialization and satisfactory sexual intercourse were achieved.

CONCLUSION

Functional, histological and anatomical results were reached despite the graft detachment. New technologies such as 3D printing facilitate the development of techniques using tailored molds.