Giant hysteromyoma after vaginoplasty in a woman with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: case report and review of the literature

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disorder characterized by congenital absence of both the uterus and vagina. Some patients require surgery to create a neovagina, however, the preservation of a nonfunctional rudimentary uterus after surgery may lead to long-term complications. Herein, a rare case of a giant hysteromyoma after vaginoplasty, in a 31-year-old Chinese female patient who was diagnosed with MRKH syndrome, is reported. The patient, who had undergone vaginal reconstruction 4 years previously, presented with abdominal distension for the previous 2 weeks. Transabdominal ultrasonography showed a firm mass of approximately 10 × 10 cm in the lower abdomen. The patient subsequently underwent an exploratory laparotomy, and a leiomyoma from her rudimentary uterus was removed. Beside this case, seven cases, published between 2004 and 2020, were identified during a literature search. Findings of the present and previously published cases suggest that gynaecologists should pay particular attention to the risks of pelvic complications in female patients with MRKH syndrome who have previously undergone surgery, and select appropriate therapeutic methods.

Results of treatment of fifty children with persistent cloaca in one center

BACKGROUND: The preserved cloaca is a particular type of anorectal anomaly. The combination of urological, genital, and rectal abnormalities makes radical reconstruction difficult. MATERIALS AND METHODS: This study examined operations performed in 50 patients with persistent cloaca treated from 2010 to 2021. Two groups are presented: the first with 35 children and a short canal (3 cm), and the second with 15 children and a long canal (3 cm). We examined the prognosis for bowel control, the type of operation, the need for vaginal reconstruction, complications after surgery, and the days of hospital stay. RESULTS: Anomalies of the Mllerian ducts in the second group (94%) were higher than in the first (36%) (p 0.001). The sacral index and myelodysplasia did not differ in both groups. The sacral index in the first group was 0.62 0.14, and in the second group, it was 0.58 0.14 (p = 0.520). Myelodysplasia in the first group was 33%, and in the second group, it was 38% (p = 0.744). Total urogenital mobilization (51%) was used in the first group, and abdominal reconstruction (54%) was used in the second group. Vaginal reconstruction was required in 28% of patients in the first group and 60% in the second group. Complications were 3.5 times more likely in the first group (60% versus 17% in the second) (p = 0.003). The length of hospital stay in patients in the second group was longer than that of patients in the first group. CONCLUSION: Our study data demonstrate that the reconstruction of a persistent cloaca requires individual planning of the operation, considering the length of the canal and the state of all structures forming the cloaca.

Giant Hysteromyoma After Vaginoplasty in a Woman With Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome: Case Report and Review of the Literature

Background: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disorder characterized by congenital absence of both the uterus and vagina. Some patients may need an operation to create a neovagina. However, the preservation of nonfunctional rudimentary uteri after surgery usually leads to some long-term complications. Case presentation: We report a rare case of a giant hysteromyoma after vaginoplasty in a woman with MRKH syndrome. A 31-year-old Chinese woman who was diagnosed with MRKH syndrome and received vaginal reconstruction 4 years ago presented with abdominal distension for half a month. Transabdominal ultrasonography showed a firm mass of approximately 10 x 10 cm in the lower abdomen. She then received an exploratory laparotomy, and a leiomyoma from her rudimentary uterus was removed.Conclusions: Gynecologists should pay attention to the risks of pelvic complications in women with MRKH syndrome who have undergone previous surgery and then choose suitable therapeutic methods.

Scaffold strategies combined with mesenchymal stem cells in vaginal construction: a review

Tissue engineering has provided new treatment alternatives for tissue reconstruction. Advances in the tissue engineering field have resulted in mechanical support and biological substitutes to restore, maintain or improve tissue/organs structures and functions. The application of tissue engineering technology in the vaginal reconstruction treatment can not only provide mechanical requirements, but also offer tissue repairing as an alternative to traditional approaches. In this review, we discuss recent advances in cell-based therapy in combination with scaffolds strategies that can potentially be adopted for gynaecological transplantation.

XCM Biologic Tissue Matrix xenograft and autologous micromucosa graft for vaginal reconstruction in Mayer-Rokitansky-Küster-Hauser syndrome

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome can be treated through numerous surgical and nonsurgical methods. We present a surgical technique in which a neovagina was reconstructed and shaped by a vaginal expander with acellular porcine dermal matrix (XCM Biologic Tissue Matrix) and mucosal interposition using microfragments harvested from the hymen. In our case, we found this procedure to be safe and effective, resulting in satisfactory sexual function and good cosmetic results, without donor site morbidity. To our best knowledge, this tissue-engineered biomaterial has never been used for vaginal reconstruction before.