STUDY OF NEWLY MODIFIED DAVYDOV’S NEOVAGINA CREATION TECHNIQUE IN PATIENTS OF MRKH SYNDROME

Dinesh Devidas Pratapwar*, Anil Panditrao Sakhare, Namdev Marutirao Bhure, Sarika Pramod Zunjare, Sampada Vinayakrao Gore and Vaishali Patawar

ABSTRACT

Introduction: MRKH (Mayer-Rokitansky-kuster-Hauser) syndrome is not a very rare entity with the incidence of 1:4000-5000 female births. The common presentation is primary amenorrhoea and is characterized by uterine and vaginal agenesis. There are many surgical methods to create neovagina but there is no consensus on the best one. Here we are presenting the new and simple modification of Davydov’s periotoneal vaginoplasty, only posterior peritoneal flap pull down, which is safe and effective and can be done by gynecologist with average laparoscopy skills. Aims and Objectives: To assess the anatomical and functional outcome of new modification of Davydov’s peritoneal vaginoplasty. Material and Methods: Total 18 patients were treated with this method from January 2018 to March 2025. Only posterior peritoneal flap pull down method is used. Postoperatively regular dilatation of neovagina is advised for 3 months. Sexual intercourse is allowed after 3 months of surgery. At the end of 6 months the anatomical and functional success of the procedure is assessed by vaginal length, breadth and FSFI-6 score. Results: The average surgical time is 61 min with average blood loss of 86 ml. The average hospital stay is 10 days. There were 2 rectal and 1 bladder injury. No postoperative complications. The average vaginal length achieved was 7.3 cm and breadth 3.2cm. The average FSFI-6 score was 25.3. Only 3 patients have mild dyspreunia. Conclusion: Our new modification of Davydov’s peritoneal vaginoplasty is easy to perform, safe and effective method of creating neovagina in patients with MRKH syndrome.

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