Laparoscopic Correction for Absence of Vagina
Center for Women’s Care & Reproductive Surgery First to Offer Minimally
Invasive Solution for Rare Anomaly, MRKH Syndrome
Kristina Henry, a Texas woman in her
early thirties who had experienced her first painful and terrifying
surgery at age 16 to correct MRKH syndrome, or failure of vaginal
development, recently sought out the Center for Women’s Care &
Reproductive Surgery in Atlanta more than half her lifetime later for
much-needed corrective work.
Although her original surgery had been
performed in a major, prestigious Eastern medical school, her emotional
scars from the experience are still almost as palpable as the visible
scarring on the insides of both thighs from the original procedure.
“I remember waking up in the recovery
room screaming in pain,” said patient Kristina Henry of her six-hour
surgery, followed by a month’s recuperation.
“When my doctor would come to check on
me, I felt like I was a test monkey. There were quite a lot of doctors
and students that saw parts of me that very few people have seen to this
day. The whole experience was painful and unbearable.”
Describing one physician’s approach she
said, “He thought I was going to go straight from surgery and start
having sexual intercourse, so he took out my stent that was supposed to
stay in, according to my original doctor. I was supposed to dilate and
at 16 that was not a top priority for me. It hurt and I was so tired of
pain. After time this made my length decrease and eventually it
decreased to barely nothing. To this day I cannot wear a swimsuit
without a cover-up because my scars are very noticeable.”
Undetected Until Puberty
Up to a half million women in the U.S.
are born with anomalies of the urinary and reproductive system. In
females thousands of these mullerian anomalies, including the absence of
a vagina, may not be discovered until the girl reaches puberty.
(Mayer-Rokitansky-Kuster-Hauser) syndrome includes failure of the
vaginal development, whether or not the uterus is present. Adolescent
girls with MRKH syndrome and obstruction defects may complain that they
have not begun menstruation, labeled primary amenorrhea.
In some cases, female patients have
discovered their anomaly after inability to have intercourse because of
an absent vagina. For many, multiple painful attempts of intercourse
have led to distortion of existing external genital structures and
scarring of the area, as well as chronic pelvic pain.
In 2005, the Center for Women’s Care &
Reproductive Surgery in Atlanta became the sole location in the U.S. to
correct this problem laparoscopically with the use of pelvic
Laparoscopy for Vaginal
Aplasia, or Non-Development of the Vagina
Techniques for correction over
the years involved use of segments of the rectum, sigmoid colon and
small intestine, as well as skin graft. In 1993 Dr. L.V. Adamyan
developed a laparoscopy-assisted technique for creation of the
neovagina, using the pelvic peritoneum.
This minimally invasive
technique is far easier on the patient, as it involves only tiny
incisions and is performed in less than an hour. More than one thousand
of them have been performed, proving their efficacy.
The procedure allows achievement
of adequate functional vaginal length and elasticity, and the peritoneal
epithelium (cellular layer that lines the walls of the abdominal cavity)
converts into normal vaginal epithelium within three months after
World-renowned head of the
Center for Women’s Care & Reproductive Surgery, Thomas L. Lyons, M.D.,
and his Fellow, Assia A. Stepanian, M.D., learned the technique
firsthand from its author, and they are the only U.S. surgeons with
experience in laparoscopic correction of MRKH syndrome using the pelvic
This procedure was used to
correct Kristina’s post-surgical shortening of the vagina, which
occurred from previous surgeries.
“It’s very unfortunate that so
many women have these suboptimal procedures because they often fail,”
said Dr. Lyons about the old style procedure, which Kristina endured
“Most academic centers still use
the old way, which involves stretching skin over a glass tube stent and
a great deal of ‘hope’ that the tissue will re-vascularize (grow new
blood vessels) and stay healthy,” he said.
Solution Over the
Blessed with a loving husband
who told her he didn’t see her scars, Kristina wanted to have a normal
sex life but had lost most of her depth.
“I finally found Dr. Lyons
online when all of my possibilities had run out,” she said. “He is a
wonderful man, and so is his whole office. The surgery went great—little
scars and very little pain. I really think a lot of both him and Dr.
Assia Stepanian, who have been great through this whole ordeal.”
At her first check-up
post-surgery, “I was never so happy. The depth was there, something I
had never witnessed in my life. This meant a lot to me and I never
thought that day would come. I felt just minor discomfort. This is a
surgery for anyone with MRKH; this will not destroy anyone’s mental
state. It has been more than four months since my surgery; my sex life
is better and I am growing more confident with myself.”
Now Kristina is on a campaign to
get her insurance company to pay for the surgery, which was not aware of
this anomaly and had no code for it.
“This disease needs to be
mentioned more and talked about, so there is more help for young girls
going through this. The first step is this letter and trying to make
people understand this issue, get them to talk to Dr. Lyons and go from
there,” said the young woman who wants people to recognize that it the
issue is more than physical; it is mental, emotional and spiritual as
Dr. Lyons’ advanced skills in
laparoscopy and/or hysteroscopy can correct the majority of mullerian
anomalies, as well as a wide spectrum of treatments for pelvic pain and
After researching the Internet
and discovering the Center for Women’s Care at
http://www.thomasllyons.com, patients come to Dr. Lyons from around
the world for advanced laparoscopic techniques. Offices are in Atlanta,
Lake Oconee and Blue Ridge, Georgia.
Support for those with MRKH
For those who are born with
MRKH, it is not only important to obtain proper medical treatment, but
to also have a support system. Women involved with the issue have
recently created a new support and information group for women who have
MRKH, and Mothers with Daughters who have MRKH. On the site they
discuss the options open to neo-vaginal construction, and have
recommended the laparoscopic method employed by the Center for Women's
Care & Reproductive Surgery to those who seek a less invasive surgical
solution. They have requested us at the Center for Women's Care to
provide a link, and we are glad to provide it. We hope this is
beneficial and educational for those seeking more information and
Here is the MRKH Yahoo Group
Email the Center for Women's Care
Center for Women's Care &
Reproductive Surgery© 2006
1140 Hammond Drive, Suite
Atlanta, Georgia 30328.
Toll Free 1 (888) 545-0400
Metro Atlanta (770) 352-0037
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