Successful Laparoscopic Sigmoid Transposition for Cervicovaginal Agenesis in Presence of Functional Uterus; a Case Series

Background: This study has been designed to investigate the long-term outcomes of laparascopic sigmoid cervicovaginoplasty in patients with congenital cervicovaginal atresia with a functional uterus and stepwise description of surgery. Methods Seven patients with cervicovaginal atresia with a functional uterus, underwent laparoscopic sigmoid cervicovaginoplasty surgery, between 2016 and 2020. All subjects underwent a successful surgery with no major complications. Mean follow-up duration was 25.9 months (2-48 months). All the patients had regular menstrual cycles. The average length of vagina was 8.9 cm (7.6-10.5 cm). In one patient, proximal stenosis of neovagina was observed 12 months after surgery. Results The mean age and BMI of the patients were 18y (12-27y) and 19.7 (17.6-22.4). The average time period between the initiation of disease symptoms and the operation was 52.28 months (2-156 months). We had no significant post-operative short term complication. We did not perform hysterectomy in our patients either at the time of first surgery or as a result of a complication. None of our patients complained of signs of low anterior resection syndrome. Two subjects had sexual activities without dyspareunia, post coital bleeding, or malodor vaginal discharge. Conclusion Sigmoid cervicovaginoplasty is a safe and effective procedure with satisfactory long term outcomes. This surgery eliminates the psychological burden of hysterectomy in these patients. Through preserving the uterus, patients may have a chance of possible future pregnancy if abdominal cerclage is performed.