PTU - Polskie Towarzystwo Urologiczne
list of articles:

Laparoscopic colpopoiesis using an isolated sigmoid segment
Article published in Urologia Polska 2003/56/2.


Wiesław Urbanowicz 1, Jerzy Starzyk 2, Michał Wolnicki 1, Marek Górniak 1, Janusz Sulisławski 1
1 Klinika Urologii Dziecięcej Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie
2 Klinika Endokrynologii Dzieci i Młodzieży Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie


vaginal agenesis, laparoscopic colpopoiesis, sigmoid


Purpose. Sigmoid vaginoplasty is an alternative technique lor vaginal replacement. A major disadvantage is the need of an extensive laparotomy. Our main goal was to avoid laparotomy and its consequences.
Patients and method. This laparoscopic procedure was done in 6 girls, mean age was 17y and 5 months. All of the patients had Mayer-Rokitansky-Kusler-Hauser syndrome. We have used 4 ports. After isolating a segment of the sigmoid using two endostaplers we made an incision in the deepest pail of vaginal vestibule. Performing a blunt dissection, a two-linger wide space was created between the posterior wall of the urethra, bladder and the rectum. In the top of thus created space peritoneum was incised under laparoscopic control. This allow the passage of a forceps from the perineum which enabled the descent of the Isolated sigmoid segment. The graft was fixed to the mucosum of the vaginal vestibule using single sutures. The continuity of the intestinal tract was restored using a circular mechanical suture through the rectum.
Results. None of the operated girls needed a conversion to an open surgery. In all 6 patients no significant blood loss or any other complication were noted. The average length of postoperative stay was 8 days.
Conclusion. This report suggest that laparoscopic sigmoid vaginal replacement is a feasible and safe operation and may be employed as an alternative procedure.


  1. 1. Frank RT: The formation of an artificial vagina without operation. AmObstel Gynecol 1938: 35: 1053.
  2. 2. Baldwin JF: The formation of an artificial vagina by intestinal trasplan-tation. Ann Surg 1904; 40: 398.
  3. 3. Zangl A: Konstruktion iter vagina durch sigmatransposition. Langcn-beck\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\'s Arch C-hir 1955: 339: 413.
  4. 4. Pratt JH: Sigmoidovaginostomy: A new method of obtaining satisfacto-ry vaginal depth. Am J Obstet Gynecol 1961:40: 535.
  5. 5. Turner-Warwick R. Kirby RS: The construction and reconstruction ofthe vagina with the colocecum. Surg Gynec & Obst 1.990: 170: 132. \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\'
  6. 6. Mclndoe AH. Banister JB; An opertionfor the cure of congenita! ab-sence of the vagina. J Obstet Gynecol Br Common 1938: 45: 490.
  7. 7. Claret I. Castanon M. Rodo J: Neovagina con injerto librę dc mucosavesical (tecnica ortiginai de Claret) Libro de actas del XXVIII Congre-so de la Sociedad Espanola de cirurgia Fediatrica, Lloret do Mar. Spain. June 15-19, 1988; p. 40.
  8. 8. Tsirulnikov MS: Creation d\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\'un vagin artificial a I\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\'aide du peritoine pe-Ivien. J Gynecol Obstet Biol Reprod 1984; 13: 821.
  9. 9. Wee JTK: A new technique of vaginal reconstruction using neovascularpudendal thigh flaps: A preliminary report. Plast Reconslr Surg 1989:83:701.
  10. 10. Hensle TW. Reiley EA: Vaginal replacement in children and young adults. I Urol 1998: I 59: 1035.
  11. 11. Urbanowicz W. Górniak M, Wolnicki M: Vaginal reconstruction using an isolated sigmoid segment in patient with testicular feminisa-tion syndrome. Surg Childh Intern 1999; VII, 2: 115.
  12. 12. Parsons JK, Gearharl SL, Gearhart JP: Vaginal reconstruction utiliziruj sigmoid colon: Complication and long term results. J Pediatr Surg2002; 37:629.
  13. 13. Ikuma K. Ohashi S. Koyasu Y: Laparoscopic colpopoiesis using sigmoid colon. Surg Laparosc findosc 1997: 7: 60.
  14. 14. Ota II. Tanaka J, Murakami M: lAiparoscopy asisted Rugę procedure for the creation of a neovagina in patient with Mayer-Rokitansky--Kuster-Hauser syndrome. Ferli Stcril 2000: 73: 641.
  15. 15. James GB, Raymond AL: Mclndoe procedure for vaginal agenesis: result and complications. Mayo Clin Proc 1989: 64: 758.
  16. 16. Souza AZ. MalufM, Perin PM: Surgical treatment of congenital uterovaginal agenesis: Mayer-Rokitaitsky-Kuster-Hauser syndrome. Int Surg 1987: 72:4.5.
  17. 17. Del Rossi C, Attanasio A. Domenichelli V: Treatment of the May-er-Rokilanksy -Kuster-Hauser syndrome in Bangladesh: Result of 10 total vaginal replacement with sigmoid colon at a missionary hospital. J Urol 1999: 162: 1138.
  18. 18. Hitchcock RJI. Malone PS: Colovaginoplasty in infants and children. BrJ Urol 1994: 73: 196.
  19. 19. Bailer. MM. Dibenedetto, Elmo G: Laparoscopic sigmoid vaginal replacement. American Academy of Pediatric Section on Urology, San Francisco, October 20, 2001, str. 158.


Wiesław Urbanowicz
Klimka Urologii Dziecięcej
Uniwersytecki Szpital Dziecięcy
ul. Wielicka 265
30-663 Kraków
tel.: (O-12) 658-20-11 wew. 1590