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CONGRESS OF THE ESPU
VD-18 (VS without presentation)
LAPAROSCOPIC SIGMOID VAGINOPLASTY
Andrea BALTHAZAR
1
, David LANNING
2
and C. D. Anthony HERNDON
1
1) VCU Health System, Urology, Richmond, USA - 2) VCU Health System, PEDIATRIC SURGERY, Richmond, USA
PURPOSE
Mayer-Rokitansky-Kuster-Hauser syndrome (MRKHs) is a congenital anomaly of the female
genital tract that may require vaginal reconstruction. Laparoscopic sigmoid vaginoplasty allows
adequate anatomic and physiologic functions that are essential for sexual-wellbeing. The goal of
laparoscopic sigmoid vaginoplasty is a to create a functional self-lubricating vagina via minimally
invasive procedure.
MATERIAL AND METHODS
A 16 year-old female diagnosed with MRKHs syndrome. We used a four port laparoscopic ap-
proach. The selection of the sigmoid graft was based on preserving the left colic artery and an
adequate length of vascular pedicle to ensure a tension free graft. Sigmoid continuity was restored
using a side-to-side linear stapled anastomosis. The sigmoid graft was rotated 180 degrees bring-
ing the proximal end into the pelvis. A transperineal hand sewn anastomosis was done to create
a neovagina.
RESULTS
A functional neovagina was created using sigmoid graft measuring approximately 8 cm in length
and two fingers in width. Sigmoid neovagina has advantages including its own inherent blood sup-
ply, inherent lubrication and distensiblility. There was no intra-operative or post-operative bowel
complication. There were no early or functional complications to date.
CONCLUSIONS
Laparoscopic vaginoplasty using a sigmoid pedicle graft lends itself to a minimally invasive
technique that can be offered to certain patients in need of vaginal reconstruction. It is an ideal
procedure for patients with MRKHs.
VD-19 (VS without presentation)
URETERORENOSCOPIC REMOVAL OF A FOREIGN BODY
IN A NEWBORN FOLLOWING FETAL NEPHROSTOMY
Alexander SPRINGER
Medical university Vienna, Paediatric Urology, Vienna, AUSTRIA
PURPOSE
To report newborn ureterorenoscopic removal of a foreign body left in the renal pelvis following
prenatal placement of a left nephrostomy.
MATERIAL AND METHODS
Intraoperative video and case report using case notes.
RESULTS
A female fetus was diagnosed with a huge sacrococcygeal teratoma and fetal left nephrostomy was
placed together with intra-uterine drainage of tumor cysts in a different center. The tumor together
with the stents and nephrostomy were removed in another center. However, a 2 cms piece of metal
had been left in the left renal pelvis causing urinary tract infection. At age 3 months (body weight
4.2 kgs) we ureterorenoscopically removed the foreign body from the left renal pelvis.