IMR Press / CEOG / Volume 50 / Issue 1 / DOI: 10.31083/j.ceog5001001
Open Access Original Research
Case Series of Mayer–Rokitansky–Küster–Hauser Syndrome: Analysis of 17 Cases
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1 Department of Obstetrics and Gynecology, Keio University School of Medicine, 160-8582 Tokyo, Japan
2 Department of Obstetrics and Gynecology, Tachikawa Hospital, 190-0022 Tokyo, Japan
*Correspondence: (Yusuke Kobayashi)
Academic Editor: Christos Iavazzo
Clin. Exp. Obstet. Gynecol. 2023, 50(1), 1;
Submitted: 7 September 2022 | Revised: 21 October 2022 | Accepted: 31 October 2022 | Published: 5 January 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: The Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome is a rare disorder characterized by congenital vaginal defects and uterine traces. Because of its rarity, standardized management for MRKH syndrome is unavailable. This study reviewed the management of the patients with MRKH syndrome in our institution. Methods: Using medical records, we retrospectively reviewed the surgical techniques, outcomes, postoperative management methods, and outpatient follow-up of 17 patients with MRKH syndrome in Keio University Hospital. Results: Of the 14 patients who requested vaginoplasty, 12 underwent surgery with Davydov’s modified procedure after the Frank method, and it took 17 months to 34 months (median two years) for the vaginal cavity to enlarge by 5–6 cm. The Frank method is a non-surgical dilation with instrumental stretching of the vaginal vestibular mucosa. Davydov’s procedure is a surgical vaginoplasty in which the vesicoureteral space is coated by the peritoneum. Although one patient lost 3800 mL of bleeding from the plexus vein and four needed to remove the prosthesis under anesthesia about one month after surgery, all patients achieved anatomic success with a vaginal cavity length of 6 cm or more and could have sexual intercourse with their sexual partners. However, two patients interrupted their preoperative hospital visits, and three were lost to follow-up postoperatively. Two of the three patients who did not accept vaginoplasty presented myoma at uterine trace and underwent myomectomy. Another one was scheduled for surgery through psychological support. Conclusions: Davydov’s modified procedure is effective, and dilating the vaginal cavity adequately using the Frank method before surgery is needed to ensure sufficient vaginal length with less perineum. During the operation, attention is required to care for the plexus vein. Comprehensive psychological support, providing appropriate information to the patient for mental maturity, and planning surgery according to their life stages are essential for successful treatment.

clinical management
congenital vaginal defects
Davydov's modified procedure
Frank method
MRKH syndrome
Fig. 1.
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