Creatsas Modification of Williams Vaginoplasty for Reconstruction of the Vaginal Aplasia in Mayer–Rokitansky–KüSter–Hauser Syndrome Cases

Abstract

Mayer–Rokitansky–Küster–Hauser syndrome has a prevalence of one in 4000 females and is the most common cause of vaginal aplasia. Management of Mayer–Rokitansky–Küster–Hauser syndrome patients includes, along with psychological support, the creation of a neovagina. Creatsas vaginoplasty is a fast and simple technique in which a perineal skin flap is used to create a perineal pouch. Initially, the hymen is cut to avoid hemorrhage during the patient's first intercourse, and a U-shaped incision is made at the perineum. Afterwards, the tissues are mobilized and the inner skin margins of the created flap are stitched together using absorbable sutures. The same material is used to approximate the perineal muscles, subcutaneous fat and outer skin margins. In our institution, the Creatsas vaginoplasty has been performed in 200 patients over the last 23 years, with excellent results.