Creation of a neovagina following Williams vaginoplasty and the Creatsas modification in 111 patients with Mayer-Rokitansky-Kuster-Hauser syndrome

Objective: Evaluation of the Creatsas modification of Williams vaginoplasty for the creation of neovagina in patients with Mayer-Rokitansky-Kuster-Hau ser syndrome (MRKH syndrome). Design: Record of perioperative and postoperative results and complications , Follow-up evaluations of patients yearly after the operation. Setting: Division of Pediatric-Adolescent Gynecology and Gynecologic Correc tive Surgery, University of Athens (tertiary referral center). Patient(s) One hundred eleven patients with MRKH syndrome. Intervention(s): Surgical creation of neovagina using the Williams vaginopl asty technique (group A: 10 patients) or the Creatsas modification of the p revious method (group B: 101 patients). Main Outcome Measure(s): Length and width of the neovagina, and the quality of sexual life postoperatively. Result(s): A functioning vagina of 10 to 12 cm depth and 5 cm width was cre ated in eight of the patients in group A (80%) and in 98 of those in group B (97.02%). A vagina of 7 to 9 cm depth and 2 to 3 cm width was created in the rest of the patients in both groups. In group A, two wound openings wer e reported (20%); in two of the patients hemorrhage occurred during the fir st intercourse, compared to none in group B. A satisfactory sexual life was reported from 94.47o of the patients and an adequate one from 4.16% of the m. Conclusion(s): The Creatsas modification of Williams vaginoplasty is a simp le and effective technique for the creation of a functioning neovagina in y oung women with vaginal aplasia. (C) 2001 by American Society for Reproduct ive Medicine.