Neovaginal mucosa after Vecchietti's laparoscopic operation for Rokitansky syndrome: structural and ultrastructural study.

Abstract

This study was undertaken to evaluate structural and ultrastructural characteristics of the mucosa of neovaginae created by Vecchietti's laparoscopic operation for Rokitansky syndrome. Vaginoscopy and Schiller test were performed 3, 6, and 12 months after the operation in 106 patients. A biopsy specimen of the neovagina obtained 12 to 18 months after surgery in 19 patients was examined by light, scanning electron, and transmission electron microscopy. At vaginoscopy, the neovaginal mucosa appeared smooth, lacking the folds that characterize the normal vagina; 12 months after the operation, an iodium-positive epithelium was present in all neovaginae. Mild ultrastructural modifications, as compared with normal vaginal mucosa, were reduced maturation, inflammatory infiltration, and tendency to superficial desquamation. At a 12-month follow-up, the mucosa of neovaginae created by the Vecchietti technique is comparable to the normal vaginal mucosa, with mild structural and ultrastructural modifications that we believe might be due to reduced vascularization.