Comparing Anatomical and Functional Outcomes of Two Neovaginoplasty Techniques for Mayer-Rokitansky-Küster-Hauser Syndrome: A Ten-Year Retrospective Study with Swine Small Intestinal Submucosa and Homologous Skin Grafts

Figures & data

Table 1 Clinical Characteristics of the MRKH Patients in Two Groups

Parameter	Vaginoplasty Using SIS Graft (n=84)	Vaginoplasty Using Skin Graft (n=31)	P-value
Age (year)	24.12±3.78	23.52±3.38	0.415
Vaginal length before surgery (cm)	1.29±0.84	1±0.82	0.105
Urinary abnormality (n)	5 (5.9%)	3 (9.7%)	0.522
Primordial uterus with functional endometrium (n)	4 (4.8%)	2 (6.5%)	0.718

Note: Data are mean±SD (range) or n.

Table 2 Perioperative Data Related to Vaginoplasty in Mayer-Rokitansky-Küster-Hauser Syndrome Patients Using SIS Graft or Skin Graft

Parameter	Vaginoplasty Using SIS Graft (n=84)	Vaginoplasty Using Skin Graft (n=34)	P-value
Operation time (minutes)	61.13±7.17	92.1±9.47	0.001
Amount of bleeding (mL)	38.57±9.46	55.81±8.28	0.001
Intraoperative complications (n)	1	0
Total cost (CNY)	43045.11±2359.98	23500.94±2020.29	0.001

Note: Data are mean±SD (range) or n.

Figure 1 The surgical procedure of vaginal reconstruction for patients with MRKHS using SIS grafts. (a) A piece of swine small intestinal submucosa biological graft. (b) Shape the SIS graft into a cylinder. (c) Make incision at the mucous membrane between the urethra orifice and posterior perineum. (d) Divide the tissue between urethra and rectum to make a neovagina cavity. (e) Expand the neovagina cavity to 10cm in depth and 3 fingers in width. (f) Fix the SIS graft to neovagina cavity. (g) Place mould after operation.

Figure 2 The surgical procedure of vaginal reconstruction for patients with MRKHS using skin graft. (a) Skin graft harvest. (b) Shape the skin graft into a cylinder.

Figure 3 The colposcopy images of the neovaginal mucosa regenerative process of a patient after vaginal reconstruction using SIS graft. (a) A month later. (b) Three months later. (c) Six months later. (d) Nine months later. (e) Colpolypus of another patient.

Table 3 Comparison of the Sexual Functional Outcomes in the Two Groups

Parameter	Vaginoplasty Using SIS Graft (n=51)	Vaginoplasty Using Skin Graft (n=21)	P-value
Total FSFI score	27.44±1.58	25.33±2.16	0.001
>30	3	0
25–30	47	18
<25	1	3
Desire score	3.81±0.43	3.83±0.62	0.896
Arousal score	4.08±0.38	4.02±0.43	0.604
Lubrication score	5.28±0.25	4.45±0.36	0.000
Orgasm score	4.52±0.55	4.02±0.51	0.001
Satisfaction score	4.85±0.61	4.42±0.63	0.012
Comfort score	4.91±0.47	4.63±0.59	0.060

Note: Data are mean±SD (range) or n.

Table 4 Comparison of the Anatomical Outcomes of the Two Groups After Surgery (6 Months After Surgery)

Parameter	Vaginoplasty Using SIS Graft (n=84)	Vaginoplasty Using Skin Graft (n=31)	P-value
Depth of vagina after surgery (cm), n (%)	7.73±0.57	7.6±0.62	0.317
≤6	1	0
6–8	72	28
≥8	11	3
Complications, n (%)	7 (8.3%)	0
Shrinkage	1 (1.2%)	0
Granulation tissue	6 (7.1%)	0

Note: Data are mean±SD (range) or n.