The treatment of vaginal aplasia by sigmoid colon colpoplasty : our experience in Dakar

Seance of wednesday 08 october 2003 (pas de sujet Principal)

Abstract

The sigmoid colon colpoplasty or Schmid procedure consists increating a neovagina by transposition of a segment of pediculizedsigmoid colon, excluded from the digestive continuity. The aim ofthis prospective study was to report the preliminary functional resultsin 8 patients operated on with this procedure. From November12, 1998 to June 18, 2002, 8 patients (age 18 to 28 years) havingvaginal aplasia, Mayer-Rokitansky-Kuster-Hauser syndrome (7cases), Morris’s syndrome (1 case), were operated on in our depart -ment. The inability to have sexual intercourse and a primaryamenorrhea brought patients to consult a doctor in all cases. Deepnessof the vaginal cup was about 1 cm in 4 cases and 2 cm in 4cases. One case of important surgery bleeding after drilling of thevaginal cup was noted. Postoperative course was simple in 6 patientswith a 10-day average hospital stay. One case of necrosis ofthe “sigmoid colon graft” occurred 5 days after surgery. One case ofevisceration was observed 6 days after surgery requiring reoperation.Functional results were rated as good if the patient succeededin having satisfactory sexual intercourse. A psychological follow-upwas ensured for all patients Functional results were good for 7 patients.We observed in one case a stricture of the colovaginal anastomosiszone. The Schmid procedure remains a choice solution inthe treatment of vaginal aplasia, due to its relative simplicity, itsefficiency, and the rarity of complications.