Modified Wharton-Sheares-George Vaginoplasty With OASIS Graft: An Outpatient Surgical Procedure for Neovagina Creation

Study Objective

The objective of this video is to show how to perform a Wharton-Sheares-George vaginoplasty with a modification to use submucosal small intestine (SIS) graft for patients with Mayer-Rokitansky-Kuster-Hauser (MRKH) seeking surgical creation of neovagina. We aim to highlight the benefits of this approach for patients who either do not want to pursue primary dilation or who achieve a suboptimal result with primary dilation and aim to provide a step-by-step description for surgeons seeking to replicate this technique.

Design

N/A.

Setting

Tertiary care children's hospital operating room.

Patients or Participants

Patients with MRKH undergoing surgical creation of neovagina who have consented to photography/video for educational purposes.

Interventions

The creation of a neovagina according to Wharton-Sheares-George in patients with MRKH syndrome with a modification to use SIS graft for epithelial scaffolding.

Measurements and Main Results

Discussion of the surgical steps and review of the anatomic and functional results.

Conclusion

The creation of a neovagina using the Wharton-Sheares-George method does not require harvesting grafts, nor does it require an inpatient stay for prolonged traction. The procedure is efficient and offers a valuable alternative to primary dilation with low short- and long-term morbidity. By following our step-by-step description of this technique, surgeons can offer a minimally invasive surgical option that achieves a functional and anatomically result within 1 week.