Operación de Vecchietti por laparoscopia para la creación de una neovagina en el síndrome de Mayer-Rokitansky-Kuster-Hauser. Evaluación anatomicofuncional

Zamora, L.; Castelo-Branco, C.; Guix, C.; Martínez, S.; Vanrell, J.A.

doi:10.1016/S0304-5013(04)76021-5

Información del artículo

Resumen

Bibliografía

Descargar PDF

Estadísticas

Resumen

Objetivo

Analizar los resultados anatomicofuncionales de la operación de Vecchietti por laparoscopia para la creación de una neovagina

Material y métodos

Estudio tipo caso-control: grupo caso formado por 6 pacientes con el síndrome de Rokitansky a las que se creó una neovagina según la técnica de Vecchietti por laparoscopia; grupo control formado por un histórico de 5 pacientes intervenidas según la técnica de McIndoe. Se analizaron las variables: tiempo y complicaciones quirúrgicas, tiempo de estancia hospitalaria, complicaciones posquirúrgicas y longitud de vagina. Los resultados funcionales se analizaron mediante un cuestionario de sexualidad (FSFI)

Resultados

Ambos grupos presentaron resultados anatómicos similares. Se hallaron diferencias significativas en el tiempo de ingreso hospitalario y en las complicaciones posquirúrgicas. Los resultados funcionales en las pacientes con relaciones sexuales activas fueron similares a la población normal

Conclusión

Con la técnica de Vecchietti por laparoscopia, se obtienen buenos resultados anatómicos y funcionales, se reducen el tiempo de ingreso hospitalario y las complicaciones posquirúrgicas

Palabras Clave:

Síndrome de Rokitansky

Neovagina

Técnica de Vecchietti

Sexualidad

Abstract

Objective

To analyze the anatomical and functional results of laparoscopic Vecchietti’s technique for constructing a neovagina

Material and methods

A case-control study was performed. The case group was composed of 6 patients with Rokitansky’s syndrome who underwent laparoscopic Vecchietti’s procedure. The control group was composed of a historic control group of 5 patients who underwent McIndoe’s technique. The variables analyzed were operating time, surgical and postsurgical complications, length of hospital stay, and vaginal length. Functional results were evaluated using the Female Sexual Function Index (FSFI)

Results

Anatomic results were similar in both groups. Significant differences were found in length of hospital stay and postsurgical complications. Functional results in patients with active sexual relationships were similar to those in the normal population

Conclusion

Laparoscopic Vecchietti’s technique produces satisfactory anatomic and functional results and reduces postsurgical complications and length of hospital stay

Key Words:

Rokitansky’s syndrome

Neovagina

Vecchietti’s technique

Sexuality

El Texto completo está disponible en PDF

Bibliografía

[1.]

V.C. Buttram Jr..

Mullerian anomalies and their management.

Fertil Esteril, 40 (1983), pp. 159-163

[2.]

A.H. McIndoe, J.B. Bannister.

An operation for cure of congenital absence of the vagina.

J Obstet Gynaecol Br Emp, 45 (1938), pp. 490-494

[3.]

G. Vecchietti.

Creation of an artificial vagina in Rokitansky- Kuster-Hauser syndrome.

Attual Ostet Ginecol, 11 (1965), pp. 131-147

Medline

[4.]

J.F. Gauwerky, D. Wallwiener, G. Bastert.

An endoscopically assisted technique for construction of a neovagina.

Arch Gynecol Obstet, 252 (1992), pp. 59-63

Medline

[5.]

J.A. Vanrell, S. Martínez Román, C. Castelo-Branco.

Neovagina por laparoscopia. Nueva modificación a la técnica de Vecchietti.

Toko-Gin Pract, 60 (2001), pp. 195-199

[6.]

R. Rosen, C. Brown, J. Heiman, S. Leiblum, C. Meston, R. Shabsigh, et al.

The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function.

J Sex Marital Ther, 26 (2000), pp. 191-208

http://dx.doi.org/10.1080/009262300278597 | Medline

[7.]

L. Fedele, S. Bianchi, G. Zanconato, R. Raffaelli.

Laparoscopic creation of a neovagina in patients with Rokitansky syndrome: analysis of 52 cases.

Fertil Steril, 74 (2000), pp. 384-389

Medline

[8.]

W.Y. Hwang, T.S. Chang, P. Sun, T.H. Chung.

Vaginal reconstruction using labia minora flaps in congenital total absence.

Ann Plast Surg, 15 (1985), pp. 534-537

Medline

[9.]

J.T.K. Kee, V.T. Joseph.

A new technique of vaginal reconstruction using neurovascular pudendal-thigh flaps: a preliminary report.

Plast Reconstr Surg, 83 (1989), pp. 701-709

Medline

[10.]

Z.J. Chen, M.Y. Chen, C. Chen, N. Wu.

Vaginal reconstruction with an axial subcutaneous pedicle flap from the inferior abdominal wall: a new method.

Plast Reconstr Surg, 83 (1989), pp. 1005-1012

Medline

[11.]

P.H. Communal, M. Chevret-Measson, F. Golfier, D. Raudrant.

Sexuality after sigmoid colpopoiesis in patients with Mayer- Rokitansky-Kuster-Hauser syndrome.

Fertil Steril, 80 (2003), pp. 600-606

Medline

[12.]

E. Darai, O. Toullalan, O. Besse, L. Potiron, P. Delga.

Anatomic and functional results of laparoscopic-perineal neovagina construction by sigmoid colpoplasty in women with Rokitansky’s syndrome.

Hum Reprod, 18 (2003), pp. 2454-2459

Medline

[13.]

F. Borruto, S.T. Chasen, F.A. Chervenak, L. Fedele.

The Vecchietti procedure for surgical treatment of vaginal agenesis: comparison of laparoscopy and laparotomy.

Int J Gynecol Obstet, 64 (1999), pp. 153-158

[14.]

P.L. Giacalone, F. Laffargue, J.M. Faure, F. Deschamps.

Ultrasoundassisted laparoscopic creation of a neovagina by modification of Vecchietti’s operation.

Obstet Gynecol, 93 (1999), pp. 446-448

Medline

[15.]

E. Hanzal, H. Kölbl, H. Jansich.

Morphologische und funktionelle Langzeitergebnisse nach Veccietti-Operation zur Bildung einer Neovagina.

Geburtshilfe Frauenheilkd, 51 (1991), pp. 563-568

http://dx.doi.org/10.1055/s-2007-1026200 | Medline

[16.]

L.W. Popp, G. Ghirardini.

Creation of a neovagina by pelviscopy.

J Laparoendosc Surg, 2 (1992), pp. 165-173

Medline

[17.]

M. Bussacca, A. Perino, R. Venezia.

Laparoscopic-ultrasonographic combined technique for the creation of a neovagina in Mayer-Rokitansky-Kuster-Hauser syndrome.

Fertil Steril, 66 (1996), pp. 1039-1041

Medline

[18.]

D.K. Veronikis, G.B. McClure, D.H. Nichols.

The Vecchietti operation for constructing a neovagina: indications, instrumentation and techniques.

Obstet Gynecol, 90 (1997), pp. 301-304

http://dx.doi.org/10.1016/S0029-7844(97)00231-7 | Medline

[19.]

J. Keckstein, G. Buck, V. Sasse, F. Tuttlies, U. Ulrich.

Laparoscopic creation of a neovagina: modified Vecchietti method.

Endosc Surg, 3 (1995), pp. 93-95

[20.]

E. Khaler, H. Fatthy.

Laparoscopic Vecchietti vaginoplasty.

J Am Assoc Gynecol Laparoscopists, 6 (1999), pp. 179-182

[21.]

J.L. Brun, G. Belleannée, N. Grafeille, A.F. Aslan, G.H. Brun.

Longterm results after neovagina creation in Mayer-Rokitanski- Kuster-Hauser syndrome by Vecchietti’s operation.

Eur J Obstet Gynecol Reprod Biol, 103 (2002), pp. 168-172

Medline

Indexada en:

Síguenos:

Indexada en:

Síguenos:

Suscríbase a la newsletter