Comparative study of laparoscopic peritoneal vaginoplasty versus sigmoid colon vaginoplasty in the treatment of congenital absence of vagina

Abstract

Objective: This study aimed to compare laparoscopic peritoneal vaginoplasty and laparoscopic sigmoid colon vaginoplasty in patients with congenital absence of vagina, aiming to provide more robust guidance for clinicians and patients with congenital absence of vagina in choosing the most appropriate surgical approach.

Methods: Patients with congenital absence of vagina who underwent laparoscopic vaginoplasty in our hospital from 2011 to 2023 were included in this study. Participants were divided into two groups: the laparoscopic peritoneal vaginoplasty group (peritoneal group, n = 20) and the laparoscopic sigmoid colon vaginoplasty group (sigmoid colon group, n = 30). Short-term outcomes (operative duration, intraoperative hemorrhage, postoperative ventilation time, time to resume oral intake, length of postoperative hospital stay,) and long-term outcomes (sexual satisfaction, vaginal discharge odor, complications, vaginal mold duration) were evaluated.

Results: Comparative analysis revealed that the peritoneal group demonstrated significantly reduced operative duration (p < 0.01), accelerated postoperative ventilation recovery (p < 0.01), and earlier resumption of oral intake (p < 0.01). No significant intergroup differences were observed in intraoperative blood loss (p = 0.10), length of postoperative hospital stay (p = 0.52), or vaginal discharge odor (p = 1). The peritoneal group had shorter vaginal mold use (p < 0.05) and higher sexual satisfaction (p < 0.01). While the peritoneal group showed a trend toward lower postoperative complication rates (3% vs. 8%), this difference did not reach statistical significance (p = 0.53).

Conclusions: Laparoscopic peritoneal vaginoplasty demonstrates superior perioperative outcomes, optimized intestinal function restoration, reduced requirement for vaginal mold application, and improved sexual satisfaction in patients with congenital absence of vagina. This procedure shows promise as a preferred surgical approach in clinical practice.

Keywords: Congenital absence of vagina; Laparoscopic peritoneal vaginoplasty; Laparoscopic sigmoid colon vaginoplasty.

Fig. 1

Flow chart of the study