Vaginal Atresia- MRKH Syndrome: Absent Vagina has a cure ( Congenital anomaly cured at Puberty) скачать в хорошем качестве

Vaginal Atresia- MRKH Syndrome: Absent Vagina has a cure ( Congenital anomaly cured at Puberty)

Absent Vagina of the isolated entity where 1/5 to 1/3 of the segment is converted to a fibrosed segment classically and in many cases entire segment is completly atretic and fibrous replacement from perineum to the cervix presents at puberty as painful monthly abdominal cycles of progressive haematometra that is picked up by an observant mother / paediatrician Needs reconstruction ! wile the mullerian structures are laden with blood filled space and pent up. The ideal correction of creating a uniform tubularised cavity that has cruciate incised cervix to the 12-15 cm segment of intestine ( pref sigmoid / Ileal) over two vascular pedicles thus of adult length suffices the tardy monthly menstrual periods ' compared to MRKH syndrome of complete Mullerian aplasia with absence of both uterus and cervix , while ovaries being functional leaving them to many a times present later than the Vaginal atresia counterparts as they have no pain of collecting Haematometra . IN both cases of creation of adult vagina by intestinal vaginoplasty , the axis kept of vertical alignment with Proximal end in the latter closed and fixed to the sacral promontory towards maintaining axis and preventing prolapse.Volume dilatation by calibration by the caregiver or the patient progressively keeps the introitus intact from precenting stenosis and preventing external contraction / fibrosis limiting the adult tube. The minimal mucus at the introitus for the first few months changes its amount by metaplasia of the inner lining and gives a new organ. A woman with capability again !! and finally a cure of a congenital condition at the age with right tissue - a gold standard. Have taken this challenge to reconstructing entire abdominal segment of MRKH by Robotic technique aided with staplers in past cases.