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A new era for treating vaginal aplasia using transretropubic balloon vaginoplasty approach
Atef Mohammad Darwish1, Ahmad Mostafa Mohammad
1Woman's Health University Center, Assiut University, Assiut, Egypt. atef_darwish@yahoo.com
Objective:
To test the efficacy, safety, and tolerability of a novel surgical alternative for formation of a neovagina in patients with vaginal aplasia.
Design:
Technique and instrumentations.
Setting:
A specialized endoscopic surgery center.
Patient(S):
Four patients with complete vaginal aplasia, three of them without a uterus and one with a functioning uterus.
Intervention(S):
A silicone Foley catheter sutured to the distal end of a sharp curved needle with a wide eye attached to a plastic handle and passed extraperitoneally into the space of Retzius followed by its inflation and upward traction for 8 days. Clinical and magnetic resonance imaging (MRI) follow-up were done.
Main Outcome Measure(S):
Operative time, complication rate, tolerability of traction and retraction, reintervention rate, width and length of the newly formed vagina, and postoperative feasibility of intravaginal sexual intercourse for married cases.
Result(S):
The results were satisfactory (normal length and width of neovagina), without complications and with acceptable tolerability and normal sexual life within 8-10 days postoperatively for the married women.
Conclusion(S):
Both clinical and MRI follow-up confirmed that retropubic balloon vaginoplasty is a simple, fast, tolerable, safe, and available extraperitoneal procedure. It can be easily done by any gynecologist having basic knowledge of the anatomy of the retropubic space.
