Creation of a neovagina in Rokitansky patients with a pelvic kidney: comparison of long-term results of the modified Vecchietti and McIndoe techniques

Abstract

Objective: To evaluate perioperative data and long-term results of Rokitansky patients with a pelvic kidney that underwent the McIndoe and modified Vecchietti procedures.

Design: Retrospective descriptive study.

Setting: A tertiary referral center for the study and treatment of Rokitansky syndrome.

Patient(s): Eleven patients with Rokitansky syndrome.

Intervention(s): Two and nine patients, respectively, underwent the McIndoe and Vecchietti modified techniques.

Main outcome measure(s): Anatomic success was defined as a neovagina > or =6 cm long allowing easy introduction of two fingers within 6 months postoperatively. Functional success was considered achieved when the patient reported satisfactory sexual intercourse starting from 6 months postoperatively.

Result(s): Surgery was performed with no complications in all 11 patients. The mean duration of surgery was 190 +/- 14.1 minutes in the first group and 32 +/- 6.4 minutes in the second group. At 14 years of follow-up, both patients who underwent McIndoe vaginoplasty had a mean +/- SD length and width of 8.2 +/- 0.4 cm and 5 cm and negative Schiller's test 24 months postoperatively. At 4 years of follow-up, eight out of the nine patients who underwent the Vecchietti procedure (89%) had a mean +/- SD length and width of the neovagina of 7.4 +/- 0.6 cm and 4.2 +/- 0.5 cm and iodine-positive vaginal-type epithelium coating 100% of the neovagina 24 months postoperatively.

Conclusion(s): While appearing to be safe, effective, and with optimal functional results, the modified Vecchietti approach also seems to yield good anatomical and aesthetic results along with shorter surgical and hospitalization times.