Prolapse of a sigmoid neovagina, created in patients with congenital vaginal aplasia or male transsexualism, is rare. In correcting this condition, preservation of coital function and restoration of the vaginal axis should be of primary interest.
One patient with Mayer-Rokitansky-Küster syndrome developed a protrusion of the sigmoid neovagina almost 4 years after the initial operation. The prolapse was treated successfully using an abdominal approach to suspend the neovagina to a Cooper ligament. The second patient is a male-to-female transsexual who developed a prolapse 3 years after the creation of a sigmoid neovagina. After suspension of the neovagina to a Cooper ligament, the prolapse recurred; in a repeat approach, the neovagina was successfully suspended to the sacral promontory. The third patient, with Mayer-Rokitansky-Küster syndrome, complained of a protrusion immediately after creation of the neovagina. Initially, the redundant sigmoid was resected vaginally. However, the prolapse recurred, and an abdominal suspension to a Cooper ligament was performed. Finally, after 1 year, another recurrence was treated successfully with a vaginal approach.
Prolapse of an artificially created vagina is a rare occurrence, without a standard treatment. Both abdominal and vaginal approaches may be needed to restore the neovagina without compromising its function.
"Those dilatations may lead to the formation of fistulas extending from the vagina to other organs, and epidermoid carcinoma has been described  . Moreover, although stenosis is rarely observed in bowel vaginoplasties performed using grafts of the colon and ileum, the risks of continuous discharge, prolapsus, operative procedure(s) requiring a prolonged operative period, bleeding, and infection are elevated  , while the risk of intestinal complications, including ileus due to fibrous adhesions (bridle ileus) and anastomotic leaks, is increased. In addition, colonic vaginoplasty elevates the risk of neoplasia in the vagina . "
[Show abstract][Hide abstract] ABSTRACT: Hematometrocolpos is the result of vaginal obstruction and can become an emergency in the pubertal period. The treatment of imperforate hymen is well defined, but the treatment of vaginal atresia is more complex. We report a case of hematometrocolpos secondary to distal vaginal atresia that was operated on in the pubertal period. The patient had isolated distal atresia without persistence of the urogenital sinus. A combined abdominal laparoscopic and perineal approach and a posterior vaginoplasty were carried out. Finally, an abdominoperineal pull-through was successfully performed. Neovagina was successfully developed with this method. The embryology and literature are reviewed. The classification, indications, and surgical technique are discussed. We suggest that this procedure is suitable for patients with vaginal agenesis and a normal uterus.
Journal of Pediatric Surgery 04/2012; 47(4):e13-5. DOI:10.1016/j.jpedsurg.2011.11.070 · 1.39 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The treatment of Mycobacterium butyricum-induced arthritis with honey bee (Apis mellifera) venom was studied in Sprague-Dawley rats. Bee venom (1mg/kg-1), injected every 5 days for 30 days, suppressed the inflammatory response to the adjuvant as measured in the swelling of the hind feet. Up to the 15th day of the study, the bee venom-injected rats showed just as much inflammation (measured in hind paw swelling) as the saline-treated adjuvant group. Beginning at day 20 and continuing until the 90th day, the bee venom-treated group had significantly reduced swelling compared to the saline-treated group. Radiographs of the hind paws taken at days 60 and 90 confirmed that the bee venom-treated group had less soft tissue swelling and less arthritic change in the ankle joints than the saline-treated group. The finding of decreased swelling in the bee venom-treated group suggests that the venom has an anti-inflammatory effect on adjuvant-induced arthritis in the rat model.
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