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Hum. Reprod. Advance Access published online on August 17, 2006
Human Reproduction, doi:10.1093/humrep/del315
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received February 5, 2006
Revised July 5, 2006
Accepted July 10, 2006

A Case Report

Laparoscopic creation of a neovagina and recovery of menstrual function in a patient with Rokitansky syndrome: A Case Report

L. Fedele 1 *, S. Bianchi 1, N. Berlanda 2, A. Bulfoni 2, and E. Fontana 1

1 Dipartimento di Ostetricia, Ginecologia e Neonatologia, Fondazione ‘Policlinico-Mangiagalli-Regina Elena’, Università di Milano, Italia
2 Clinica Ostetrico-Ginecologica dell’Università di Milano, Ospedale San Paolo, Milano, Italia

* To whom correspondence should be addressed.
L. Fedele, E-mail: luigi.fedele{at}unimi.it


  Abstract

A 16-year-old woman experiencing primary amenorrhoea and cyclic pelvic pain was diagnosed with Rokitansky syndrome, which was characterized by the absence of the uterus and the upper two-thirds of the vagina, normal salpinges and ovaries and a 4 x 3 cm Müllerian remnant containing functioning endometrium located near the left adnexa. With a combined laparoscopic-vaginal operation, the remnant was anastomized with the apex of the retrohymenal fovea. The operation allowed not only the creation of a neovagina but also the recovery of a regular menstrual activity and the theoretical restoration of the reproductive capacity of this patient. An accurate pre- and intra-operative evaluation of patients with Rokitansky syndrome is necessary to identify those who might benefit from this procedure.

Keywords: laparoscopic surgery/Müllerian anomalies/primary amenorrhea/Rokitansky syndrome.
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