LAPAROSCOPIC VAGINOPLASTY PROCEDURE USING A MODIFIED PERITONEAL PULL-DOWN TECHNIQUE WITH UTERINE BUD FLAP IN PATIENTS WITH MAYER–ROKITANSKY–KÜSTER–HAUSER SYNDROME.

Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome is a congenital malformation characterized by the defective development of the Müllerian ducts resulting in the absence of a functional vagina and uterus in the presence of normally functioning ovaries. [1] As a result, conception and vaginal sexual activity are compromised. In patients with MRKH syndrome, the creation of a neovagina allows for satisfactory sexual intercourse, and uterus transplantation (UTx) can allow patients with MRKH syndrome to give birth. [2] Several surgical and nonsurgical techniques for creating an adequately sized and functional neovagina to allow for sexual intercourse have been developed for patients with MRKH syndrome. [3],[4] However, the surgical method with the best anatomical and functional outcomes is controversial due to a lack of comparative studies. In addition, various materials have been used to cover the newly created space. The laparoscopic Davydov procedure is one of the most commonly used techniques, in which multiple complications have been observed.[5,6] Therefore, various modied laparoscopic procedures have been developed.[7,8,9] In this report, we describe a novel laparoscopic vaginoplasty procedure, using a pull-down technique of the peritoneal aps with additional structural support to the neovaginal apex using the incised uterine bud in patients with MRKH syndrome and report the anatomical and functional outcomes of our case series. [10]