Mayer-Von Rokitansky-Kuster-Hauser Syndrome (MRKHS) or congenital vaginal aplasia affects maybe one in 5,000 female infants. These girls are born without a vagina, but have normal uteri, ovaries, and external secondary sex organs such as breasts. Because they do not have a vagina, they do not have a menses; they cannot give birth when they mature, nor can they have sexual intercourse without intervention. Diagnosis doesn’t usually occur until they try to have sexual intercourse for the first time.

Most girls without vaginas who seek treatment will use dilators to create a normal size vagina after instructed in proper technique by physicians. Since the vagina has such potential for stretching this technique usually works well. Even those who have a vagina surgically created will probably have to use dilators to keep the vagina open. Many go untreated because they are too embarrassed to talk about it.

If the vaginal dilator therapy is unsuccessful, the next step is to create a vagina surgically. For the past three decades the procedures used were highly invasive, lengthy, and painful, such as skin grafting using split-thickness skin or full-thickness skin. The harvested skin grafts from the buttocks or upper thigh were reshaped over a vaginal stent to form a neovagina or new vagina, however; this didn’t always create an ideal vagina.

Then the preferred method became using isolated bowel segments. The most commonly used replacement is a sleeve of distal sigmoid colon for successfully creating a capacious neovagina. Because of prolonged recovery time, and significant scarring, surgical procedures have turned to using Laparoscopic methods and short-term results are encouraging.

Even more encouraging is a new break through, which utilizes stem cells to build new vaginal tissue. Cells are removed from where the vagina should be, and then an enzyme is used to break down the vaginal cells into stem cells, which then generate new mucosal tissue on their own. In about 15 days, the new layer of tissue is thick enough to transplant into the patient.

Dr. Cinzia Marchese of Rome's Policlinico Umberto I hospital, a professor of clinical pathology and biotechnology, not only had the vision for this treatment but, sees its potential for treating women with cancer and other vaginal disorders.


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