PMC5288454_01
A preoperative physical examination; B 1-month postoperative examination.
gr1.jpg
PMC5288454_01_gr1.jpg
fig0005
During the physical examination, she had age-appropriate secondary sexual characters, normal female external genitalia with a small vaginal pouch of approximately 2 cm (Fig. 1A). Finally, the neovagina was delivered to the vaginal introit (Fig. 1B). During the follow-up, the patient not presented vaginal stenosis (Fig. 1B) or other complication.
A Magnetic resonance imaging demonstrating the cervical atresia and the vaginal agenesis.
gr2.jpg
PMC5288454_01_gr2.jpg
fig0010
The ultrasound demonstrated an anteflexed uterus of 7.6 x 3.6 x 4.2 cm, an endometrium of 5 mm with normal adnexa and absence of cervix and proximal vagina; this was corroborated by a magnetic resonance of the pelvis (Fig. 2).
A Resection of the sigmoid colon; B Longitudinal incision; C-D Retubularization; E 6-month postoperative vaginography.
gr3.jpg
PMC5288454_01_gr3.jpg
fig0015
The rectovesical pouch was dissected laparoscopically assisted, then, the laparotomy was done, and the neovagina created using the technique described by Tu et al., and Garcia-Roig et al. (Fig. 3). An 8-10 cm of the sigmoid colon was resected, taking great care that the vascular supply was kept in the middle portion of the isolated segment (Fig. 3A). The sigmoid section was opened on its anterior border 1 cm from the mesenteric edge (Fig. 3B) and retubularized longitudinally in two layers (Fig. 3C-D).