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Evaluation of Vaginal Function in Post Sigmoid Vaginoplasty Surgery


Objectives: Sigmoid vaginoplasty procedure is one of the surgical procedures selected as the management of vaginal agenesis cases. This technique results in a functional vaginal opening as a way out of menstrual blood as well as in sexual activity.


Methods: A retrospective study from medical record was performed to vaginal agenesis cases that underwent sigmoid vaginoplasty surgery at Dr Sardjito Hospital Yogyakarta Indonesia in 2016-2017. The surgical procedure was performed with laparotomy and vaginal approach.


Results: Sigmoid vaginoplasty was performed on 10 cases. In two patients without uterus, 1 case was diagnosed with Complete Andogen Insensitivity Syndrome (CAIS), and 1 case was Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH). Eight cases of vaginal agenesis had functional uterus. No previous history of surgery was reported in two cases, while eight cases are with history of surgery. Five patients were married (including two patients who did not have a uterus), five others were single.


The length of sigmoid colon preserved as a graft was about 15-20cm. All of the distal ends of the sigmoid colon graft were able to reach the vaginal introitus. No complications were found during the surgery. Post-surgical evaluation was done routinely every week, then every month up to 3 months post-surgery, and every half to a year later.


From postoperative evaluation, of 5 people who had been married, 4 of them had been able to penetrate during sexual activity. Two people needed help using lubrication and vaginal dilatation before penetration, while 2 others were able to penetrate without help. One person had not been able to penetrate and still in the process of vaginal dilatation. Five other patients were single and did not engage in sexual activity, had a uterus with regular menstrual cycles, no dysmenorrhea nor other complaints.

Conclusion: Sigmoid colon vaginoplasty is a surgical procedure for cases of congenital vaginal absence that produces satisfactory results. There is no postoperative dyspareunia, dysmenorrhea, results in good cosmetic appearance with relatively low complications.