Total Laparoscopic Colocolpopoiesis in a Kidney Transplant Recipient With Frasier Syndrome.

Abstract

BACKGROUND:

The absence of a normal functioning vagina can have a profound impact on women's quality of life and psychological well being. Frasier syndrome is a rare autosomal recessive disorder which presents with male pseudohermaphroditism with gonadal dysgenesis, renal failure in early adulthood and increased risk of developing gonadoblastoma. Kidney transplant recipients are reported to have a high complication rate after colorectal surgery, most probably resulting from immunosuppressive therapy.

CASE:

A 25-year-old female kidney transplant recipient with Frasier syndrome consulted our department to discuss the possibilities of surgically constructing a functional vagina. She successfully underwent a total laparoscopic colocolpopoiesis without any complications. A sigmoid segment of 16 cm long was isolated laparoscopically and transferred caudally in a dissected pouch between bladder and rectum on its vascular pedicle. There was no short-term morbidity and no complications up to 3 years postoperatively. She experienced no neovaginal symptoms and was able to engage in neovaginal penetration by means of vibrator or neovaginal dilatator.

CONCLUSIONS:

The positive results in this patient lead us to recommend laparoscopic colocolpopoiesis in kidney transplant patients who are seeking vaginoplasty. We advocate considering a total laparoscopic approach whenever rectosigmoid colocolpopoiesis is indicated, even after a kidney transplantation.

• Authors: Mark-Bram Bouman, Wouter B van der Sluis, Shaikh A Nurmohamed, Anne van Tellingen, Wilhelmus Jhj Meijerink
• Journal: Female pelvic medicine & reconstructive surgery (Female Pelvic Med Reconstr Surg) Vol. 22 Issue 1 Pg. e11-3 ( 2016) ISSN: 2154-4212 [Electronic] United States
• PMID: 26516816 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Artificial Organs
• Colon, Sigmoid (transplantation)
• Female
• Frasier Syndrome (surgery)
• Humans
• Kidney Transplantation
• Laparoscopy (methods)
• Treatment Outcome
• Vagina (surgery)