Does the Vecchietti procedure produce normal vaginal depth? Am a transgender woman with Vaginal Stenosis. Was not a consistent dilator and that may be part of the explantation. Tammy
We have reviewed several publication on the Vecchietti procedure and would prefer to quote directly. As you know the Vecchietti procedure employs a racket which is placed on the lower abdominal skin. By twisting the mechanism tension sutures draw an olive shaped bogie from the perineum or vaginal introitus (opening) upwards and this creates a neovagina. However the average depth achieved is about 7 cm or 2.7 inches. Doubt most sexually active females would be happy with that.
Vecchietti’s laparoscopic procedure is simpler and faster than the modified Davydov procedure, which also requires a perineal step. The only significant difference is the greater length of the neovagina obtained by the Davydov approach; however, the difference in length has not been reported to impact on sexual quality of life.16 Davydov’s
Fig. 1. Perforation of the blind vaginal dimple.
Fig. 2. Curved thread guide inserted sub-peritoneally.
Fig. 3. The vaginal dummy.
Fig. 4. The traction device.
16 SAJOG • January 2013, Vol. 19, No. 1
procedure17 is particularly useful for patients with abnormalities of the
external genitalia, such as female hypospadias, owing to the vaginal
step of this approach. However, the presence of a pelvic kidney or
previous pelvic surgery contraindicate this procedure. (credit to Dr. Ma’ad Aljubouri, from Iran)
Long-Term Outcomes of Laparoscopic Bean (Olive) Vaginoplasty (Modified Vecchietti Procedure) for Mayer-Rokitansky-Kuster-Hauser Syndrome.
Çetin C1, Soysal C1, Ürünsak İF1, Api M2, Çetin T1.
The objective of our study is to evaluate the long-term results of laparoscopic bean vaginoplasty (LBV), which we previously described.
MATERIALS AND METHODS:
From April 2002 to September 2013, 62 patients, who were diagnosed with Mayer-Rokitansky-Kuster-Hauser Syndrome and underwent LBV in Cukurova University School of Medicine Department of Obstetrics and Gynecology were included in the study. Operative data, complication rates, vaginal length, and sexuality of patients during the follow-up period were evaluated. Sexuality of the patients were evaluated using the Female Sexual Function Index (FSFI) questionnaire. The FSFI scores were compared with age-matched 65 healthy control subjects.
Mean age of patients in case and control groups were 23.9 ± 5.1 (18-32) and 25.1 ± 4.2 (18-31), respectively (P = .69). Median length of follow-up after surgery was 48 months (24-144 months). No complications occurred during the operations. No vaginal adhesions occurred during the follow-up periods. Median vaginal length during the last follow-up was 7 cm (6-9 cm). FSFI scores were similar with the control group.
LBV is a successful modification of Vecchietti procedure, without any reported complication. However, the procedure should still be compared with the other methods in randomized trials.
Harold M. Reed, M.D.
The Reed Centre for Transgender Surgery – Miami