Results of laparoscopic davydov technique in 47 patients with congenital absence of the vagina: laparoscopic peritoneal vaginoplasty.

Abstract

OBJECTIVE: To evaluate the technical feasibility and anatomical and functional outcomes of laparoscopic Davydov technique (transvestibular vaginoplasty with pelvic peritoneum) for the patients with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. METHODS: This study was a retrospective review of prospectively collected data of 47 women with MRKH syndrome between 2005 and 2011. Clinical examination, pelvic ultrasound, intravenous urography and/or renal ultrasound, laparoscopy, karyotyping, orthopedics and ears, nose, and throat examination, magnetic resonance imaging was performed and 47 patients with MRKH syndrome underwent surgery with the procedure. Their clinical, surgical, and follow-up data were recorded and the functional outcome was assessed by a brief and valid self-report questionnaire evaluating female sexual life (Female Sexual Function Index, FSFI). A control group was recruited to compare the results. RESULTS: The mean operative time was 117.2 +/- 35.3 minutes. Two intra-operative rectal and one bladder injury were repaired without sequels. One patients had vault granulation at the neovagina, which healed after electric cautery and one patient had mild enterocele. The mean length of the neovagina was 8.3 +/- 1.1 cm (range, 6 to 11 cm) without any shrinkage at the follow-up of 18.9 months (range, 6 to 53 months) after operation. The neovaginal introitus admitted two fingers in width in all patients. There was no statistical difference in the total FSFI between the case and control groups. CONCLUSION: Laparoscopic Davydov is a safe, effective treatment of MRKH syndrome with minimal invasion and a relatively low complication rate. The procedure has satisfactory anatomical and functional results. This technique offers advantages such as: short operating time and hospital stay, no particular instrumentation required and no external scars. Sexuality approaches so-called 'normal sexuality.'