Treatment of the Mayer-Rokitansky-Küster-Hauser syndrome with autologous in vitro cultured vaginal tissue. descriptive study of long-term results and patient outcomes

OBJECTIVE: Evaluating sexual function and quality of life (QoL) in patients treated with a modified Abbé-McIndoe technique using in vitro cultured autologous vaginal mucosa. DESIGN: Descriptive study. SETTING: Policlinico Umberto I, "Sapienza" University of Rome. POPULATION: From 2006 to 2016, 39 women affected by Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) underwent vaginoplasty at our center using a modified Abbé-McIndoe technique with in vitro cultured autologous vaginal tissue. METHODS: For each patient, vaginal tissue was obtained by full-thickness biopsy of the vaginal vestibule. Following enzymatic dissociation, cells were cultured for 2-3 weeks before the transplant. MAIN OUTCOME MEASURES: Each patient completed two validated questionnaires to quantify sexual function and QoL: the Female Sexual Function Index (FSFI), administered at 12, 36 and 60 months, and the Psychological General Well Being Index (PGWBI) administered at 0, 6 and 36 months after surgery. RESULTS: Twelve months after surgery, 29 patients have engaged in regular sexual activity. The FSFI test results show a satisfactory sexual function compared to general population, with a median at 12 months of 25.85 (range 4.6-30.5), 36 months of 27.2 (range 4.4-33.6) and 60 months of 29.6 (range 23.9-33.6). The PGWBI questionnaire shows a median score of 420.5 (range 108-540) before surgery, and 459 (range 252-533) at the last follow-up. CONCLUSIONS: Vaginoplasty performed with the use of autologous vaginal tissue, besides ensuring a long-term satisfying sex life, helps in achieving an improvement in QoL that is maintained over time.