Amniotic Membrane as Allograft for Construction of Neovagina by McIndoe Technique in Vaginal Agenesis

BACKGROUND: To assess the anatomical and functional results of neovagina creation with amniotic membrane.

METHODS: We operated on three young women with vaginal agenesis two of whom had a diagnosis of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome and the other mixed gonadal dysgenesis. The mean age was 29.67 years (range 28-33). A fresh amniotic membrane retrieved from a Cesarean section on the same operation date was prepared over a mould and inserted into the newly formed tunnel between the bladder and the rectum as per McIndoe technique. The patients were followed up for one year minimum.

RESULTS: Mean vaginal depth achieved was 8, 10 and 7 cm (average 8.3 cm) at the 12 month follow-up clinic. Two patients expressed having satisfactory sexual life at follow-up interview. One patient who had infrequent coitus and neglected appropriate use of mould needed further follow-up in clinic and self-dilation.

CONCLUSİONS: McIndoe vaginoplasty with fresh-homologous amniotic membrane is an effective low-risk procedure. It can produce good results in fairly short time span with modest demand on patient compliance and rare morbidity.