Neovagina in Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome: Vaginoplasty Using Ileal Flap

Sílvia Serrano; Inês Pereira; Alexandra Henriques; Alexandre Valentim Lourenço

doi:10.20344/amp.18563

Autores

Sílvia Serrano Department of Obstetrics, Gynecology and Reproductive Medicine. Hospital de Santa Maria. Centro Hospitalar Universitário Lisboa Norte. Lisbon. https://orcid.org/0000-0002-0544-2698
Inês Pereira Department of Gynecology and Obstetrics. Hospital CUF Descobertas. Lisbon; Department of Gynecology and Obstetrics. Hospital CUF Torres Vedras. Torres Vedras.
Alexandra Henriques Department of Obstetrics, Gynecology and Reproductive Medicine. Hospital de Santa Maria. Centro Hospitalar Universitário Lisboa Norte. Lisbon; Lisbon School of Medicine. Lisbon Academical Medical Center. Lisbon.
Alexandre Valentim Lourenço Department of Obstetrics, Gynecology and Reproductive Medicine. Hospital de Santa Maria. Centro Hospitalar Universitário Lisboa Norte. Lisbon; Lisbon School of Medicine. Lisbon Academical Medical Center. Lisbon.

DOI:

https://doi.org/10.20344/amp.18563

Palavras-chave:

Procedimentos Cirúrgicos Reconstrutivos, Transtornos 46, XX do Desenvolvimento Sexual/cirurgia, Vagina/cirurgia

Resumo

Introdução: O tratamento cirúrgico de doentes com malformações do trato genital feminino é um problema complexo. Existem diferentes técnicas descritas na literatura cujo objetivo é a reconstrução de uma neovagina anatomicamente semelhante a uma vagina, com comprimento adequado para facilitar o funcionamento sexual e o menor risco de complicações possíveis. O objetivo deste estudo é descrever a técnica cirúrgica para reconstrução de uma neovagina a partir de um segmento ileal sem pedículo vascular.
Material e Métodos: Apresentamos uma técnica cirúrgica desenvolvida num centro universitário terciário numa doente com síndrome de Mayer-Rokitansky-Küster-Hauser.
Resultados: A cirurgia de vaginoplastia com segmento ileal foi realizada em três etapas. Na primeira etapa de intervenção foi realizada uma histerectomia laparoscópica com salpingectomia bilateral. A segunda etapa consistiu no isolamento do segmento ileal, anastomose ileal e preparação do segmento ileal. De seguida, o segmento ileal isolado foi reposicionado num molde de vagina para configurar a neovagina. Finalmente, a terceira etapa incluiu a adaptação do molde vaginal com a mucosa ileal ao espaço vesico-rectal.
Conclusão: A vaginoplastia com segmento ileal sem pedículo vascular é uma opção que pode ser utilizada para reconstrução da vagina, pois proporciona um excelente tecido para reposição vaginal. Esta técnica pode ser utilizada em doentes com malformações do trato genital com ausência ou hipoplasia da vagina.

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