Laparoscopically Assisted Uterovaginal Canalization and Vaginoplasty for Patients with Congenital Cervical and Vaginal Atresia: A Step-By-Step Guide and Long-Term Outcomes.

STUDY OBJECTIVE: To study the long-term outcomes of laparoscopically assisted uterovaginal canalization and vaginoplasty in patients with congenital cervical and vaginal atresia and to introduce the surgery step-by-step.

DESIGN: A prospective observational study launched from January 2016 to Sep 2019.

SETTING: A tertiary teaching hospital.

PATIENTS: 10 women diagnosed with congenital cervical and vaginal atresia.

INTERVENTION: All women underwent laparoscopically assisted uterovaginal canalization and vaginoplasty.

MEASUREMENTS AND MAIN RESULTS: All procedures went smoothly, with no case requiring conversion to laparotomy or no intraoperative complications occurred. Postoperative febrile morbidity occurred in 1 patient (1/10, 10%). The median (quartile) follow-up time was 26.0 (21.3, 48.3) months. All patients resumed menstruation, including 9 patients (9/10, 90%) with regular monthly menstruation. 8 patients (8/10, 80%) experienced mild-to-moderate dysmenorrhea; the remaining 2 patients (2/10, 20%) had no dysmenorrhea. Cervical restenosis occurred in 1 patient (1/10,10%) 12 months postoperatively, and cervical dilation was performed. So far, 8 months after the second surgery, no restenosis has been found. The mean postoperative vaginal length was 7.9±1.3cm by the time of last follow up. Only 1 patient prepared for pregnancy for two years, but she had not conceived yet.

CONCLUSION: Laparoscopically assisted uterovaginal canalization and vaginoplasty is an easy, safe and promising management option for correcting congenital cervical and vaginal atresia.