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• W2160438985 abstract "BackgroundFollowing vaginoplasty or creation of a neovagina for females born with vaginal agenesis or septae, it is imperative to maintain vaginal patency to prevent stenosis or closure of the vagina. While stents are commonly used to maintain patency, many patients are frustrated with daily responsibilities required of stents.Objective(s)To report the novel the use of a pessary to maintain vaginal patency following vaginoplasty or neovaginoplasty for Mullerian anomalies or agenesis.Materials and Method(s)A Regula silicone folding pessary (Milex, Cooper Surgical, Trumbull, CT) was used to maintain vaginal patency for 3 patients following vaginoplasty or neovaginoplasty. Patient A was a 15-year-old status post a McIndoe procedure for vaginal agenesis with a functioning uterus. She developed obstructed menses due to vaginal stenosis at the graft apex 12 months post-operatively. After lysis of adhesions, a Regula pessary was placed at the apex for 12 weeks. Patient B was a 32-year-old who underwent a McIndoe procedure for Mullerian agenesis who had a skeletal deformity with shortened arms preventing self-placement of a vaginal stent. Since the patient would not initially be able to insert a stent to maintain patency, a Regula pessary was placed in the upper vagina. After six weeks, it was removed under anesthesia. Patient C was an 18-year-old with a history of transverse vaginal septum excision 6 years prior that had required 3 subsequent surgeries for vaginal stenosis. After a fourth procedure for relief of stenosis, a Regula pessary was placed at the area that had been stenosed, left in place for 8 weeks and then removed in the office.Result(s)Six months after removal of the pessary, Patient A has normal vaginal patency and regular menses. Patient B is now 15 months status post her procedure with normal vaginal patency and sexual activity. Patient C is 6 months status post lysis of adhesions for vaginal stenosis and has normal vaginal patency.Conclusion(s)Use of a pessary to maintain vaginal patency is a viable option for patients following vaginoplasty or neovaginoplasty. Two groups that may most benefit are those with disabilities preventing easy insertion of a dilator and those who have failed use of a dilator to maintain patency following previous vaginoplasty.SupportNone. BackgroundFollowing vaginoplasty or creation of a neovagina for females born with vaginal agenesis or septae, it is imperative to maintain vaginal patency to prevent stenosis or closure of the vagina. While stents are commonly used to maintain patency, many patients are frustrated with daily responsibilities required of stents. Following vaginoplasty or creation of a neovagina for females born with vaginal agenesis or septae, it is imperative to maintain vaginal patency to prevent stenosis or closure of the vagina. While stents are commonly used to maintain patency, many patients are frustrated with daily responsibilities required of stents. Objective(s)To report the novel the use of a pessary to maintain vaginal patency following vaginoplasty or neovaginoplasty for Mullerian anomalies or agenesis. To report the novel the use of a pessary to maintain vaginal patency following vaginoplasty or neovaginoplasty for Mullerian anomalies or agenesis. Materials and Method(s)A Regula silicone folding pessary (Milex, Cooper Surgical, Trumbull, CT) was used to maintain vaginal patency for 3 patients following vaginoplasty or neovaginoplasty. Patient A was a 15-year-old status post a McIndoe procedure for vaginal agenesis with a functioning uterus. She developed obstructed menses due to vaginal stenosis at the graft apex 12 months post-operatively. After lysis of adhesions, a Regula pessary was placed at the apex for 12 weeks. Patient B was a 32-year-old who underwent a McIndoe procedure for Mullerian agenesis who had a skeletal deformity with shortened arms preventing self-placement of a vaginal stent. Since the patient would not initially be able to insert a stent to maintain patency, a Regula pessary was placed in the upper vagina. After six weeks, it was removed under anesthesia. Patient C was an 18-year-old with a history of transverse vaginal septum excision 6 years prior that had required 3 subsequent surgeries for vaginal stenosis. After a fourth procedure for relief of stenosis, a Regula pessary was placed at the area that had been stenosed, left in place for 8 weeks and then removed in the office. A Regula silicone folding pessary (Milex, Cooper Surgical, Trumbull, CT) was used to maintain vaginal patency for 3 patients following vaginoplasty or neovaginoplasty. Patient A was a 15-year-old status post a McIndoe procedure for vaginal agenesis with a functioning uterus. She developed obstructed menses due to vaginal stenosis at the graft apex 12 months post-operatively. After lysis of adhesions, a Regula pessary was placed at the apex for 12 weeks. Patient B was a 32-year-old who underwent a McIndoe procedure for Mullerian agenesis who had a skeletal deformity with shortened arms preventing self-placement of a vaginal stent. Since the patient would not initially be able to insert a stent to maintain patency, a Regula pessary was placed in the upper vagina. After six weeks, it was removed under anesthesia. Patient C was an 18-year-old with a history of transverse vaginal septum excision 6 years prior that had required 3 subsequent surgeries for vaginal stenosis. After a fourth procedure for relief of stenosis, a Regula pessary was placed at the area that had been stenosed, left in place for 8 weeks and then removed in the office. Result(s)Six months after removal of the pessary, Patient A has normal vaginal patency and regular menses. Patient B is now 15 months status post her procedure with normal vaginal patency and sexual activity. Patient C is 6 months status post lysis of adhesions for vaginal stenosis and has normal vaginal patency. Six months after removal of the pessary, Patient A has normal vaginal patency and regular menses. Patient B is now 15 months status post her procedure with normal vaginal patency and sexual activity. Patient C is 6 months status post lysis of adhesions for vaginal stenosis and has normal vaginal patency. Conclusion(s)Use of a pessary to maintain vaginal patency is a viable option for patients following vaginoplasty or neovaginoplasty. Two groups that may most benefit are those with disabilities preventing easy insertion of a dilator and those who have failed use of a dilator to maintain patency following previous vaginoplasty. Use of a pessary to maintain vaginal patency is a viable option for patients following vaginoplasty or neovaginoplasty. Two groups that may most benefit are those with disabilities preventing easy insertion of a dilator and those who have failed use of a dilator to maintain patency following previous vaginoplasty." @default.
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• W2160438985 date "2013-03-01" @default.
• W2160438985 modified "2023-09-29" @default.
• W2160438985 title "Novel Use of a Pessary to Maintain Vaginal Patency Following Vaginoplasty or Neovaginoplasty for Mullerian Anomalies or Agenesis" @default.
• W2160438985 doi "https://doi.org/10.1016/j.fertnstert.2013.01.084" @default.
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