The Vecchietti procedure for surgical treatment of vaginal agenesis: comparison of laparoscopy and laparotomy

Objective: Our goal was to describe the outcomes of women with vaginal agen esis who had surgical creation of a neovagina using the Vecchietti techniqu e over a 20-year period. We also sought to determine whether the laparoscop ic approach would result in similar outcomes as laparotomy. Method: Retrosp ective analysis of 76 women with vaginal agenesis treated at the University of Verona Hospital between 1976 and 1996 with the Vecchietti procedure. Op erative and postoperative records were reviewed, and sexual histories were obtained. Data were analyzed based on surgical approach and postoperative s exual satisfaction. Continuous data were analyzed with student's t-test, an d categoric data were analyzed using Fisher's exact test. Result: Those who underwent the Vecchietti procedure with a laparoscopic approach (N = 7) ha d similar complication rates (0% vs. 13.0%, P = 0.59) and postoperative neo vaginal depth (74.9 mm vs. 73.7 mm, P = 0.93) as those with laparotomy (N = 69). Similar proportions of women reported inadequate vaginal lubrication (28.6% vs. 17.4%, P = 0.61) and sexual satisfaction (100% vs. 78.3%) in the laparoscopy and laparotomy groups as well. Operative complications, neovag inal depth, or degree of lubrication were not good predictors of sexual sat isfaction. Conclusion: Outcomes in those women who underwent the Vecchietti technique via the laparoscopic approach are comparable to those who underw ent laparotomy. (C) 1999 International Federation of Gynecology and Obstetr ics.