Abbe McIndoe Procedure Vs Singapore Flap for Neovaginal Reconstruction in Mayer-Rokitansky-Küster-Hauser Syndrome: A Prospective Interventional Study
PC08-PC12
Correspondence
Dr. S Arun Prasath,
Assistant Professor, Department of Plastic Surgery, SRM Medical College Hospital and Research Centre, Kattankulathur, Chengalpattu District-603203, Tamil Nadu, India.
E-mail: arunpras1@srmist.edu.in
Introduction: Congenital uterovaginal agenesis is a condition wherein, although the secondary sexual traits usually develop, the lack of a uterus and vagina leaves the patients unable to conceive and experience sexual fulfillment. A well-done neovaginal repair is essential for enhancing the psychological and social effects on women.
Aim: To compare the Abbe McIndoe technique and the Singapore flap, which are frequently used for vaginal reconstruction.
Materials and Methods: This prospective interventional study was conducted over three years at the Department of Plastic Surgery, SRM Medical College Hospital and Research Center, Kattankulathur, Tamil Nadu, India. Twelve patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome were included, with six undergoing the Abbe McIndoe procedure and six undergoing the Singapore flap procedure. This study assessed operative time, hospital stay, neovaginal length, complications, mould use, donor site morbidity, and sexual satisfaction. Data were analysed using Statistical Package for the Social Sciences (SPSS) version 26.0, with a p-value of <0.05 considered statistically significant.
Results: The mean±SD age of participants was 22.6±4.16 years in both groups. The mean±SD operative time was slightly longer for the Singapore flap (127±8.37 minutes) compared to the Abbe McIndoe procedure (123±13.03 minutes). The Singapore flap group had a more extended hospital stay (11.17±1.32 days vs. 9.17±1.94 days) but achieved a greater mean neovaginal length (9.28±0.25 cm vs. 8.88±0.61 cm). The Singapore flap group experienced fewer complications, with no late complications and only one immediate complication, compared to the Abbe McIndoe group, which had two late and two immediate complications. Mould use was not required in the Singapore flap group, while it was variable in the Abbe McIndoe group. The Singapore flap group had no donor site morbidity compared to four cases in the Abbe McIndoe group. Sexual satisfaction was higher in the Singapore flap group, with five patients reporting ‘good’ outcomes than three in the Abbe McIndoe group.
Conclusion: The Singapore flap technique demonstrated superior outcomes in neovaginal reconstruction for MRKH syndrome, with fewer complications, no need for postoperative moulds, no donor site morbidity, and higher sexual satisfaction. These findings suggest that the Singapore flap may be a preferred technique for neovaginal reconstruction in appropriate clinical settings.