Pre-Conference Workshop - Beyond the Basics: Navigating Complex Urogynecologic Surgeries with Confidence-Congenital Vaginal Reconstruction

Congenital Vaginal Reconstruction

Pdf Summary

The presentation from the American Urogynecologic Society focuses on congenital vaginal reconstruction techniques, specifically the McIndoe method and the use of grafts. Dr. Cassandra Kisby, an Assistant Professor at Duke University, leads the discussion, also noting a potential conflict of interest due to her consultancy with Cosm Medical and a shared patent pending on a 3D-printed vaginal mold.<br /><br />Dr. Kisby emphasizes the importance of a multidisciplinary approach in treating structural abnormalities of the genitourinary tract. Key surgical techniques discussed include the McIndoe, Vecchietti, and Davydov methods, applicable to congenital abnormalities requiring pelvic reconstructive surgery.<br /><br />Candidates for these procedures are carefully evaluated, starting with a comprehensive history and physical exam. Imaging, such as ultrasound and MRI, is critical, and patient psychological readiness is also considered. A significant focus is placed on distinguishing between different types of vaginal and uterine anomalies, such as Müllerian agenesis and various forms of uterine defects, using an interactive classification system.<br /><br />Specialized surgical methods like neovagina creation and the use of grafts, both biological and split-thickness, are explored. Graft selection requires careful consideration due to factors like potential pork product content and shrinkage.<br /><br />The presentation also covers the psychological support and patient counseling necessary for successful outcomes, including dilation and possible surgical interventions. For those not ready for such surgeries, non-surgical options like catheterization are suggested.<br /><br />Lastly, Dr. Kisby highlights her work with the Duke Genitourinary Anatomic Differences (GU CARES) Program, advocating for a collaborative approach to case management, involving various specialties, to ensure the most successful patient outcomes.

Keywords

congenital vaginal reconstruction

McIndoe method

grafts

Dr. Cassandra Kisby

multidisciplinary approach

genitourinary tract

Müllerian agenesis

neovagina creation

Duke GU CARES Program

3D-printed vaginal mold