Objective: The study objective was to evaluate use of oxidized regenerated cellulose (Surgicel®) for epithelialization of neovagina in vaginal agenesis. Design: A prospective, longitudinal study (Canadian Task Force classification II-2) was conducted at a tertiary care center. Method: Ten (10) women (ages: 17–25 years) with vaginal agenesis, undergoing surgical construction of vagina over a period of 2 years, were included in the study. The surgical technique involved creation of a neovagina by modified Sheares technique, followed by use of a foam mold covered with a condom and further wrapped in oxidized cellulose to aid epithelialization. The main outcome measures evaluated were effectiveness and complications (if any) with the use of oxidized cellulose for epithelialization of neovagina. Results: There were no intraoperative complications. Adequate vaginal length (7–10 cm) was achieved in all cases on foam mold removal. On follow-up at 6 months, all vaginas were well epithelialized. One (1) patient had granulation tissue persisting for the initial 8 weeks, after which the vagina healed well. One (1) patient did not use a glass mold postsurgery and had partial stenosis; except for this patient, none had coital difficulty. Conclusions: Vaginal reconstruction using oxidized cellulose is a safe and effective procedure, with minimum complications and good success rates. Unlike amnion grafts, there is no risk of transmission of infections. (J GYNECOL SURG 26:189)
GriffinJE, EdwardsC, MaddenJD, HarrodMJ, WilsonJD. Congenital absence of the vagina: The Mayer-Rokitansky-Kuster-Hauser syndrome. Ann Intern Med, 1976; 85:224.
3.
VecchiettiG. Creation of an artificial vagina in Rokitansky-Kuster-Hauser syndrome [in Italian]Attualita Ostet Ginecol, 1965; 11:131.
4.
ShearesBH. Congenital atresia of the vagina: A new technique for tunneling the space between bladder and rectum and construction of the new vagina by a modified Wharton technique. J Obstet Gynaecol Br Emp, 1960; 67:24.
5.
WhartonLR. A simplified method of constructing a vagina; report of four cases. Ann Surg, 1938; 107:842.
6.
DhallK. Amnion graft for treatment of congenital absence of vagina. Br J Obstet Gynecol, 1984; 91:279.
7.
AbbeR. New method of creating a vagina in a case of congenital absence. Med Rec, 1898; 54:836.
8.
McIndoeAH, BannisterJB. An operation for the cure of congenital absence of vagina. J Obstet Gynecol Br Emp, 1938; 45:490.
9.
HensleTW, ReileyEA. Vaginal replacement in children and young adults. J Urol, 1998; 159:1035.
10.
FaulkWP, MathewsR, StevensPJ, BennetJP, BurgosH, HsiBL. Human amnion as an adjunct in wound healing. Lancet, 1980; 1:1156.
11.
INTERCEED (TC7) Adhesion Barrier Study Group. Prevention of postsurgical adhesions by INTERCEED (TC7), an absorbable adhesion barrier: A prospective, randomized multicentre clinical study. Fertil Steril, 1989; 51:933.
12.
JacksonND, RosenblattPL. Use of interceed absorbable adhesion barrier for vaginoplasty. Obstet Gynecol, 1994; 84:1048.
13.
MotoyamaS, Laoag-FernandezJB, MochizukiS, YamabeS, MaruoT. Vaginoplasty with Interceed absorbable adhesion barrier for complete squamous epithelialization in vaginal agenesis. Am J Obstet Gynecol, 2003; 188:1260.
14.
SharmaJB, GuptaN, MittalS. Creation of neovagina using oxidized cellulose (Surgicel) as a surgical treatment in vaginal agenesis. Arch Obstet Gynecol, 2007; 275:231.
