UC Irvine

Background: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is characterized by vaginal agenesis, the treatment of which typically involves neovaginal construction using split-thickness skin grafts. While successful in many patients, this method may result in vaginal contracture or foreshortening. Neovaginal construction using full-thickness skin grafts (FTSGs) is an underutilized surgical technique associated with decreased rate of contracture and improved functional outcomes. Cases: FTSGs were used for neovaginal construction in 5 patients with MRKH syndrome. This report describes the surgical technique and the current authors' experience when using it. There was a mean follow-up time of 39.4 months (range: 9-111 months). Results: All 5 grafts have remained patent, and all of the patients who desired vaginal intercourse are now capable of achieving this. None of the 5 patients had vaginal contraction or foreshortening. Conclusions: Neovaginal construction using FTSGs is an underutilized and underreported technique in the gynecologic literature. Surgical planning, dilator use, and management of granulation tissue are important considerations when applying this technique. In the current authors' experience, the use of FTSGs in neovaginal construction for patients with MRKH has been successful, with no incidence of vaginal contraction or foreshortening.