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Colpoelongation
Last reviewed: 07.06.2024
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Due to anomalies in the intrauterine development of the genitals, in some cases the vagina may be absent, and for its creation there is such a non-surgical method as colpoelongation (from Greek kolpos - vagina and Latin elongatio - lengthening).
This method was first described in 1938 by Robert T. Frank, an American gynecologist.
Indications for the procedure
Indications for the creation of a neo-vagina by colpoelongation are congenital malformation - vaginal aplasia, Müllerian agenesis or Mayer-Rokitansky-Küster-Hauser syndrome, in which the vagina (either absent or shortened and blind) and the uterus are not formed in a fetus with female genotype during ontogenesis due to abnormal development of the Müllerian (paramesonephral) duct: Most cases have a small rudimentary uterine bulb with no functional endometrium. With age, most patients with this syndrome have primary amenorrhea, but their secondary sexual characteristics are normal.
Creating a functional neo-vagina should help women to have a normal sex life (not related to fertility).
Read also - Treatment of vaginal and uterine malformations
Preparation
The timing of the creation of a new vagina and preparation for the rather lengthy procedures of vaginal dilatation-its nonsurgical progressive self-stretching-depends on the patient. Clinical experience shows that regardless of when the diagnosis of vaginal and uterine malformations was made, treatment should not begin until late adolescence, so that the patient can understand the principles of the procedure and consent to it, as it requires a high level of self-motivation and participation in the process of prolonged therapy, which is not only tedious but also often painful.
Blood tests for sex hormone levels are taken before procedures are started, and karyotyping may be required to confirm the biological female sex.
A gynecologic examination, MRI, CT or pelvic and uterine ultrasound is mandatory. And to assess the state of the urinary system, intravenous urography.
Technique of the colpoelongation
The technique of colpoelongation consists in the use of vaginal dilators (which gradually increase in size), which are inserted with constant mechanical pressure into the fossa or depression of the vagina, located between the urethra (urethra) and the anterior wall of the rectum.
These manipulations at the first session are carried out by a gynecologist for a quarter of an hour; at the second session the patient - under the supervision of a doctor; further procedures according to the instructions received by the patient carries out independently at home: a day two or three sessions of 15 minutes each.
Follow-up should be done by the attending gynecologist at least once a month, and the procedures themselves may take several months.
Consequences after the procedure
Among the possible complications and consequences of this method of neovagina creation are bloody discharge, secondary vaginal contraction or vaginal wall prolapse, and accidental dilation of the urethra.
In addition, a proportion of patients may subsequently develop dyspareunia.