MAYER-ROKITANSKY-KUSTER-HAUSER SYNDROME (MRKH) PATIENT TREATED WITH LAPAROSCOPIC DAVYDOV PROCEDURE AT LIAQUAT NATIONAL HOSPITAL, KARACHI
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Keywords
Mayer-Rokitansky-Kuster-Hauser Syndrome, Laparoscopic Davydov Procedure, Vaginal Reconstruction, Congenital Vaginal Agenesis, MRKH Syndrome Treatment
Abstract
Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome, characterized by congenital absence of the vagina and uterus, poses significant challenges to affected individuals, particularly in terms of fertility and sexuality. We present a case of a 20-year-old woman diagnosed with MRKH syndrome who underwent laparoscopic Davydov's vaginoplasty at Liaquat National Hospital, Karachi. The patient presented with primary amenorrhea and a blind-ended vagina, with normal external genitalia and well-developed secondary sexual characteristics. Surgical intervention was chosen after thorough counseling, and the Davydov procedure was performed successfully with minimal intraoperative complications. Postoperative care involved self-dilation with Hegar dilators, leading to satisfactory neovaginal length and function. Compared to traditional methods like the McIndoe procedure, the Davydov technique offers advantages such as fewer postoperative complications and a simpler surgical approach. Our case underscores the importance of individualized treatment strategies and multidisciplinary care in managing MRKH syndrome, with laparoscopic Davydov's vaginoplasty emerging as a promising option for vaginal reconstruction. Long-term follow-up is essential to assess the procedure's efficacy and patient satisfaction.
References
2. Morcel K, Guerrier D, Watrin T, Pellerin I, Levêque J. The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: clinical description and genetics. J Gynecol Obstet Biol Reprod (Paris). 2008 Feb;37(1):539-46. doi: 10.1016/j.jgyn.2007.03.013.
3. Callens N, De Cuypere G, De Sutter P, Monstrey S, Weyers S, Hoebeke P, Cools M. An update on surgical and non-surgical treatments for vaginal hypoplasia. Hum Reprod Update. 2014 Sep-Oct;20(5):775-801. doi: 10.1093/humupd/dmu027.
4. Davydov SN. Operatsiia kol'popeza iz briushiny matochno-priamokishechnogo prostranstva [Colpopoeisis from the peritoneum of the uterorectal space]. Akush Ginekol (Mosk). 1969 Dec;45(12):55-7. Russian. PMID: 5381096.
5. Lee MH. Non-surgical treatment of vaginal agenesis using a simplified version of Ingram's method. Yonsei Med J. 2006 Dec 31;47(6):892-5. doi: 10.3349/ymj.2006.47.6.892.
6. Brucker SY, Gegusch M, Zubke W, Rall K, Gauwerky JF, Wallwiener D. Neovagina creation in vaginal agenesis: development of a new laparoscopic Vecchietti-based procedure and optimized instruments in a prospective comparative interventional study in 101 patients. Fertil Steril. 2008 Nov;90(5):1940-52. doi: 10.1016/j.fertnstert.2007.08.070.
7. Deldar-Pesikhani M, Ghanbari Z, Shahrbabaki FS, Nassiri S, Raznahan M, Shokrpour M. Comparison of modified McIndoe and Davydov vaginoplasty in patients with MRKH syndrome in terms of anatomical results, sexual performance and satisfaction. J Family Med Prim Care. 2022 Aug;11(8):4614-4618. doi: 10.4103/jfmpc.jfmpc_1939_21.
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Dr Fatima Akram
Department of Obstetrics and Gynecology, Liaquat National Hospital, Karachi - Pakistan
Dr Aisha Taj
Head of Department, Obstetrics and Gynecology, Liaquat National Hospital, Karachi - Pakistan
Dr Karam Un Nisa
Department of Obstetrics and Gynecology, Liaquat National Hospital, Karachi - Pakistan