New attempt using labio‐vestibular flap technique to manage circumcised women with Rokitansky syndrome

Objective . To assess the efficacy of the labio‐vestibular flap technique in managing circumcised women with Rokitansky syndrome and in correcting the sexuality defects caused by the anomaly present and by female circumcision. Design . A prospective, comparative, clinical study. Setting . Kasr El Aini School of Medicine, Cairo University, Egypt. Patients . Thirty‐four circumcised patients with Rokitansky syndrome were divided into 2 groups; Group 1 consisted of 22 cases treated with the labio‐vestibular flap technique, and Group 2 consisted of 12 cases treated with McIndoe's technique. Main outcome measures . Pre and postoperative clinical assessment of the newly formed vagina and sexuality. The new flap is formed of the remaining parts of the labia minora and the adjoining parts of the vestibule, and is used to cover the posterior and lateral walls. Meanwhile, the anterior wall is covered by the epithelium of the original blind vaginal pouch. The modified Kasr El Aini sexual assessment sheet assesses sexuality. Results . Rokitansky syndrome could be classified into 4 clinical types according to the degree of development of the uterus. The labio‐vestibular technique was simple and not associated with any graft rejection, hair growth or contraction of the reformed tract. Dyspareunia and marital failure were less significantly recorded in the labio‐vestibular technique than in McIndoe's technique. But, the most significant results were the improvement in sexuality, in addition to restoration of genital continuation, menstruation and fertility in some cases. Conclusion . The labio‐vestibular flab technique is the most simple and most suitable line of treatment for circumcised cases with Rokitansky syndrome. In these cases, the technique achieved good results in correcting sexual defects after circumcision.