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Updated: Jul 18, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Modified Davydov Neovaginoplasty in Patients With Mayer-Rokitansky-Kuster-Hauser Syndrome: Outcomes From an Extensive
Vittoria Benini1, Marta Parma1, Giorgia Grecchi1
1Department of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy (all authors).
Study Objective:
To evaluate surgical outcomes of modified laparoscopic Davydov procedure for neovagina creation in patients with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome.
Design:
A retrospective observational study.
Setting:
The study was conducted in a tertiary care center in Milan, Italy.
Patients:
One hundred fifteen patients affected by MRKH syndrome underwent modified laparoscopic Davydov neovaginoplasty.
Interventions:
Expert surgeons performed combined laparoscopic and vaginal neovaginal creation procedures using the modified Davydov technique. Some patients underwent laparoscopic oocyte retrieval simultaneously.
Measurements And Main Results:
One hundred fifteen patients with MRKH syndrome underwent modified Davydov procedure; 27 also had laparoscopic oocyte retrieval. We evaluated intraoperative (blood loss, operative time, complications) and postoperative (hospital stay, bladder catheter removal, postsurgical complications) data. We also analyzed vaginal length and width at 3- and 6-month follow-up intervals. Mean preoperative vaginal length was 10.1 ± 6.3 mm. Surgical time averaged 73.8 ± 21.4 minutes for neovagina creation and 107.4 ± 23.7 minutes for Davydov procedure and oocyte retrieval; the use of a vaginal trocar for peritoneal entry and vaginal cuff opening reduced mean time from 85.9 to 74.4 minutes (p = .046) without affecting anatomical outcomes. Mean blood loss was 66 ± 33 mL, with no intraoperative complications. Postoperatively, 98.3% resumed spontaneous urination within 48 h; major complications occurred in 2 cases. At 3 months, mean vaginal length was 78.7 ± 8.5 mm and width 22.5 ± 4 mm; results were stable at 6 months with 53.6% reporting normal sexual activity.
Conclusion:
The modified Davydov procedure is a safe, effective, and reproducible option for neovaginal creation in MRKH syndrome, providing excellent anatomical and functional results with minimal complications. Technical refinements improved surgical efficiency without affecting outcomes. This is the largest reported series of patients undergoing the procedure, and results support its adoption as a standard treatment of care, although further studies are needed to assess long-term outcomes.
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