Objective: The purpose of this study was to evaluate the postoperative morphologic aspects of neovaginoplasty by the McIndoe technique with the use of an oxidized cellulose membrane (Interceed®) – an absorbable adhesion barrier – to correct congenital vaginal defects. Design: This study was designed as a prospective study. Patients and Methods: The sample consisted of 10 patients treated at the Department of Urogynecology, Federal University of São Paulo, 7 patients with Mayer–Rokitansky–Küster–Hauser Syndrome, and 3 patients with congenital vaginal atresia. In order to evaluate the epithelization process, monthly biopsies for the first 3 months and then on the 9th month after neovaginoplasty using Interceed, were collected. Results: In all patients, lamina propria rich in blood vessels and epithelioid cells were found in a vaginal fragment after 1 month of the neovaginoplasty. Typical vaginal epithelium was also observed and the reaction for identification of glycogen (PAS) was positive 9 months after surgery in all cases. Conclusions: The oxidized cellulose membrane proved to be a suitable material to use as coating of the neovagina for the correction of congenital defects such as vaginal agenesis. It is possible to obtain a typical vaginal epithelium after the use of this absorbable adhesion barrier. (J GYNECOL SURG 29:169)
FrankRT. The formation of an artificial vagina without operation. Am J Obstet Gynecol, 1938; 35:1053.
6.
GargolloPC, CannonGMJr, DiamondDA, ThomasP, BurkeV, LauferMR. Should progressive perineal dilation be considered first line therapy for vaginal agenesis?J Urol, 2009; 182,Suppl 4:1882.
7.
Ismail-PrattIS, BikooM, LiaoL, ConwayGS, CreightonSM. Normalisation of vaginal length by dilator treatment alone in Complete Androgen Insensitivity Syndrome (CAIS) and Rokitansky Syndrome. Hum Reprod, 2007; 22:2020.
8.
LiaoL, DoyleJ, CrouchNS, CreightonSM. Dilation as treatment for vaginal agenesis and hypoplasia: A pilot exploration of benefits and barriers as perceived by patients. J Obstet Gynaecol, 2006; 26:144.
9.
DhallK. Amnion graft for treatment of congenital absence of the vagina. Br J Obstet Gynecol, 1984; 91:279.
10.
JacksonND, RosenblattPL. Use of Interceed absorbable adhesion barrier for vaginoplasty. Obstet Gynecol, 1994; 84:1048.
11.
Interceed® (TC7). Adhesion Barrier Study group. Prevention of postsurgical adhesions by Interceed (TC7), an absorbable adhesion barrier: A prospective, randomized multicenter clinical study. Fertil Steril, 1989; 51:933.
12.
SekibaK. The Obstetrics and Gynecology Adhesion Prevention Committee.
Use of Interceed (TC7), absorbable adhesion barrier to reduce postoperative adhesion reformation in infertility and endometriosis surgery. Obstet Gynecol, 1992; 79:518.
13.
CremaLC, Jármy-Di BellaZIK, RibaltaJCLet al.Neovaginoplasty with oxidized cellulose: Clinical and morphological evaluation. Int Urogynecol J, 2007; 18,Suppl 1:118.
14.
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.
15.
SharmaJB, GuptaN, MittalS. Creation of neovagina using oxidized cellulose (surgicel) as a surgical treatment in vaginal agenesis. Arch Gynecol Obstet, 2007; 275:231.
16.
DadhwalV, GhoshB, GuptaB, DekaD, MittalS. Oxidized Cellulose for Epithelialization of Neovagina in Vaginal Agenesis. J Gynecol Surg, 2010; 26:189.
