For the first time in Vietnam, Vaginoplasty with Autologous Sigmoid Flap was successfully performed

29/12/2021 16:19

On December 1st, Viet Duc University Hospital(VDUH) announced that a laparoscopic vaginal reconstruction surgery for a female patient diagnosed no vagina (in accordance with androgen insensitivity syndrome) had been successfully performed.

 

Despite having a lovely visage and the ideal height of a model, the young female patient, N.T.T, 29 years old, from Lang Son has never dared to date any man because of a huge womanly defect. She was born without a vagina due to androgen insensitivity syndrome. To deal with the disadvantages of the classical intestinal vaginoplasty, surgeons atDepartment of Maxillofacial, Plastic and Aesthetic Surgery, VDUH in collaborating with experts inGastrointestinal Laparoscopic Surgery to perform the Sigmoid Vaginoplasty using a part of the patient’s own large intestine. This is a difficult technique, requiring the coordination of a team of experts with extensive experience in gender determination and modern equipment, so it has only been performed in a few large centers around the world.

Assoc. Prof. Nguyen Hong Ha,MD, PhD – Head of Department of Maxillofacial, Plastic and Aesthetic Surgery said: Disorders of sex development (DSD) is a congenital condition in which the chromosomes, gonads, and anatomy of the genital are abnormal. Since 2013, the Ministry of Health has allowed 04 hospitals to perform sex reassignment surgery: National Hospital of Pediatrics, Children’s Hospital 2, National Hospital of Obstetrics and Gynecology, and Viet Duc University Hospital. At the Department of Maxillofacial, Plastic and Aesthetic Surgery of VDUH, many such surgeries have been performed such as mammoplasty, penoplasty, vaginoplasty to reassign the gender for patients with disorders of sex development.

 

According to the medical literatures, vaginoplasty is a surgical procedure for women who have no vagina due to a congenital condition or acquired vaginal abnormalities such as Mayer-Rokitansky–Kuster-Hauser syndrome (MRKHS), androgen insensitivity syndrome (AIS), or patients with tumor located in pelvis or pelvis deformed by trauma, for transwomenwho want to have gender reassignment surgery.

 

Assoc. Prof. Nguyen Hong Ha, MD, PhD, said: Previous vaginoplasties such as skin grafting, oral mucosal grafting or using traditional flaps have manydisadvantages. The vaginal depth is usually limited to only 8 – 10cm and the neovagina must be dilatedregularly for the rest of the patient’s lifespan because it can easily contract. The neo–vagina is difficult to clean, causing unpleasant odors and cannot produce naturalsecretions so it is necessary to use lubricants duringsex… The main advantage of sigmoid flap vaginoplasty is the intestinal mucosa can secrete mucuswhich acts as a natural lubricant for the neo–vagina and facilitate intercourse, the neo–vagina does not contract and can reach the ideal depth from 12 – 18cm.

 

 

Dr. Duong Trong Hien, MD, PhD – Head of Abdominal Emergency Surgery Department, VDUH shared: the intestinal flap was harvested by laparoscopic technique, more advantages compared to conventional open surgery techniques. Patients have shorterrecovery, less pain, they can start eating solid foodsearlier, less bleeding, the intestines are sutured by machine to help minimize post-operative complications such as fistula, surgical site infection, postoperative intestinal obstruction… This technique is performed by leading experts in the field of gastrointestinal endoscopic surgery of VDUH.

 

 

Dr.Ngo Hai Son, MD, MSc– a member of the surgical team who performed this operation said: Vaginal Agenesis will reduce the patient’s quality of life and affect her mental health. At present, patient T’s health is progressing well after surgery, she recovered very quickly, she is now able to eat and to engage hernormal activities. The neo–vagina has a very soft mucosa, hyperperfusion, secretes mucus moderately. Itis 14cm in depth and 2.5cm in diameter. The patient isvery happy and confident: “Now I can contemplategetting married.”