Article ; Online: Histological Features of Neovaginal Epithelium after Vaginoplasty in Mayer-Rokitansky-Küster-Hauser Syndrome.
Journal of pediatric and adolescent gynecology
2024 Volume 37, Issue 3, Page(s) 353–359
Abstract: Objective: To analyze the features of the epithelia coating neovaginas after vaginoplasty in women affected by Mayer-Rokitansky-Küster-Hauser syndrome STUDY DESIGN: We conducted a retrospective analysis of prospectively collected data. Women affected by ...
| Abstract | Objective: To analyze the features of the epithelia coating neovaginas after vaginoplasty in women affected by Mayer-Rokitansky-Küster-Hauser syndrome STUDY DESIGN: We conducted a retrospective analysis of prospectively collected data. Women affected by Rokitansky syndrome who underwent neovaginal biopsy after vaginoplasty (McIndoe surgery, intestinal vaginoplasty, Vecchietti surgery, and Davydov surgery) were included. Macroscopic mucosal features were assessed through clinical examination and the Schilling test. Each biopsy specimen was prepared for examination by light microscopy and in some cases by scanning electron microscopy (SEM). Results: Thirty-six patients (4 McIndoe, 2 intestinal vaginoplasty, 14 Vecchietti, and 16 Davydov) were included. All biopsies were performed without complications. In McIndoe's neovaginas, the mucosal microscopic features were similar to normal skin, with large areas of preserved epithelium, heterogeneous presence of dermal papillae, and superficial keratinization. The characteristics of the intestinal neovagina's surface were similar to those of a sigmoid colon, with well-shaped glands, cylindrical cells, and a secreting mucosa. In Vecchietti neovaginas, the surface the epithelium was flat and multilayered, highly similar to that of a normal vagina, with the presence of glycogen and superficial desquamation. On medium SEM magnification evaluation, the epithelium presented flattened polygonal cells. Finally, in Davydov neovaginas, none of the specimens had persistent mesothelial elements. The squamous neo-epithelium had regular aspects of differentiation with the presence of glycogen. At greater SEM magnification, microridges were evident, with a regular distribution. Conclusion: Each different technique of vaginoplasty leads to unique histological and structural features of the neovagina's mucosa. Knowledge of these elements must be the basis for the choice of the most appropriate intervention. |
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| MeSH term(s) | Humans ; Female ; Vagina/surgery ; Vagina/abnormalities ; 46, XX Disorders of Sex Development/surgery ; 46, XX Disorders of Sex Development/pathology ; Mullerian Ducts/abnormalities ; Mullerian Ducts/surgery ; Congenital Abnormalities/surgery ; Retrospective Studies ; Adolescent ; Uterus/abnormalities ; Uterus/surgery ; Surgically-Created Structures ; Adult ; Epithelium/pathology ; Young Adult ; Plastic Surgery Procedures/methods ; Biopsy ; Somites/abnormalities ; Microscopy, Electron, Scanning |
| Language | English |
| Publishing date | 2024-01-20 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 1325079-6 |
| ISSN | 1873-4332 ; 1083-3188 |
| ISSN (online) | 1873-4332 |
| ISSN | 1083-3188 |
| DOI | 10.1016/j.jpag.2024.01.002 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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