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XCM Biologic Tissue Matrix xenograft and autologous micromucosa graft for vaginal reconstruction in Mayer-Rokitansky-Küster-Hauser syndrome

  • Gomes, Tatiana Gigante (Department of Plastic, Reconstructive and Maxillofacial Surgery, Hospital of Egas Moniz, CHLO) ;
  • Agostinho, Mariana (Department of Plastic, Reconstructive and Maxillofacial Surgery, Hospital of Egas Moniz, CHLO) ;
  • Cardoso, Mariana Conceicao (Department of Obstetrics and Gynecology, Hospital of Divino Espirito Santo of Ponta Delgada, EPER) ;
  • da Costa, Joao Nunes (Department of Plastic, Reconstructive and Maxillofacial Surgery, Hospital of Egas Moniz, CHLO) ;
  • Matias, Julio (Department of Plastic, Reconstructive and Maxillofacial Surgery, Hospital of Egas Moniz, CHLO)
  • Received : 2020.04.02
  • Accepted : 2020.07.15
  • Published : 2021.03.15

Abstract

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome can be treated through numerous surgical and nonsurgical methods. We present a surgical technique in which a neovagina was reconstructed and shaped by a vaginal expander with acellular porcine dermal matrix (XCM Biologic Tissue Matrix) and mucosal interposition using microfragments harvested from the hymen. In our case, we found this procedure to be safe and effective, resulting in satisfactory sexual function and good cosmetic results, without donor site morbidity. To our best knowledge, this tissue-engineered biomaterial has never been used for vaginal reconstruction before.

Keywords

References

  1. Oppelt PG, Lermann J, Strick R, et al. Malformations in a cohort of 284 women with Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH). Reprod Biol Endocrinol 2012;10:57. https://doi.org/10.1186/1477-7827-10-57
  2. Kim SK, Park JW, Lim KR, et al. Is rectosigmoid vaginoplasty still useful? Arch Plast Surg 2017;44:48-52. https://doi.org/10.5999/aps.2017.44.1.48
  3. Morcel K, Camborieux L; Programme de Recherches sur les Aplasies Mulleriennes, et al. Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. Orphanet J Rare Dis 2007;2:13. https://doi.org/10.1186/1750-1172-2-13
  4. Committee on Adolescent Health Care. ACOG Committee Opinion No. 728: Mullerian Agenesis: Diagnosis, Management, And Treatment. Obstet Gynecol 2018;131:e35-42.
  5. McIndoe A. The treatment of congenital absence and obliterative conditions of the vagina. Br J Plast Surg 1950;2:254-67.
  6. Teng Y, Zhu L, Chong Y, et al. The modified McIndoe technique: a scar-free surgical approach for vaginoplasty with an autologous micromucosa graft. Urology 2019;131:240-4. https://doi.org/10.1016/j.urology.2019.05.020
  7. Zhu L, Zhou H, Sun Z, et al. Anatomic and sexual outcomes after vaginoplasty using tissue-engineered biomaterial graft in patients with Mayer-Rokitansky-Kuster-Hauser syndrome: a new minimally invasive and effective surgery. J Sex Med 2013;10:1652-8. https://doi.org/10.1111/jsm.12143
  8. George RS, Kostopanagiotou K, Papagiannopoulos K. The expanded role of extracellular matrix patch in malignant and non-malignant chest wall reconstruction in thoracic surgery. Interact Cardiovasc Thorac Surg 2014;18:335-9. https://doi.org/10.1093/icvts/ivt473
  9. Molinaro F, Garzi A, Cerchia E, et al. Sternal reconstruction by extracellular matrix: a rare case of phaces syndrome. Open Med (Wars) 2016;11:196-9. https://doi.org/10.1515/med-2016-0037
  10. Berthet JP, Wihlm JM, Canaud L, et al. The combination of polytetrafluoroethylene mesh and titanium rib implants: an innovative process for reconstructing large full thickness chest wall defects. Eur J Cardiothorac Surg 2012;42:444-53. https://doi.org/10.1093/ejcts/ezs028
  11. Pascual G, Sotomayor S, Adel F, et al. Remodeling of noncrosslinked acellular dermal matrices in a rabbit model of ventral hernia repair. Eur Surg Res 2016;56:32-48. https://doi.org/10.1159/000441721
  12. Kaufmann R, Jairam AP, Mulder IM, et al. Characteristics of different mesh types for abdominal wall repair in an experimental model of peritonitis. Br J Surg 2017;104:1884-93. https://doi.org/10.1002/bjs.10635
  13. Kaufmann R, Jairam AP, Mulder IM, et al. Non-cross-linked collagen mesh performs best in a physiologic, noncontaminated rat model. Surg Innov 2019;26:302-11. https://doi.org/10.1177/1553350619833291

피인용 문헌

  1. Histopathological Analysis of Decellularized Porcine Small Intestinal Submucosa after Treatment of Skin Ulcer vol.9, pp.12, 2021, https://doi.org/10.1097/gox.0000000000003967