New Laparoscopic Vaginoplasty Procedure With a Modified Peritoneal Pull-Down Technique in Four Patients With Mayer-Rokitansky-Küster-Hauser Syndrome.

Abstract Background Various vaginal reconstructive procedures have been described for patients with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. We describe the success of a novel laparoscopic vaginoplasty procedure using an anteroposterior peritoneal pull-down technique. Case Four patients with MRKH syndrome underwent a modified laparoscopic Davydov procedure using an anteroposterior peritonea pull-down technique with a transverse laparoscopic incision below the strand. Anatomical success was achieved in all patients, allowing easy introduction of two fingers, an epithelialized neovagina, and a mean length of 8.0 cm (range 7.0-9.0cm). All three patients who attempted sexual intercourse were successful, and neovagina size was adequately maintained at the long-term follow-up in the remaining patient. Summary and Conclusion This novel procedure presents as a feasible and an effective approach for vaginal reconstruction in patients with MRKH syndrome.