ULTRASTRUCTURAL-STUDY OF THE NEOVAGINA FOLLOWING THE UTILIZATION OF HUMAN AMNIOTIC MEMBRANE FOR TREATMENT OF CONGENITAL ABSENCE OF THE VAGINA

We present an ultrastructural study of the utilization of human amniot ic membrane in the treatment of congenital absence of the vagina in 10 patients. All patients were surgically treated with application of an amniotic membrane graft using the modified McIndoe and Bannister tech nique. Sixty days after surgery, samples of the vaginal neoepithelium were collected for transmission electron microscopy analysis. The ultr astructural findings consisted of a lining of mature squamous epitheli um indicating the occurrence of metaplasia of the amniotic epithelium into the vaginal epithelium. The cells were arranged in layers as in t he normal vaginal epithelium, i.e., superficial, intermediate and deep layers. There were desmosomes and cytoplasmic intermediate cytokerati n filaments, as well as some remnant features of the previous amniotic epithelium. These findings suggest that human amniotic membrane is ab le to complete metaplasia into squamous cells but the mechanism of thi s cellular transformation is unknown.