【nha cai so 1】Creating Vaginas for Women with Vaginal Aplasia

Associate Prof. Dr. Pham Anh Vu (on the right end) is nha cai so 1operating on one patient with vaginal aplasia

Could you elaborate more on this technique?

This technique can be called the technique of creating vaginas for women with congenital absence of vagina. We have been working on it since 2010, with experiences gained from the studying trips in France, and Germany. We have successfully performed surgeries for the first 3 cases in Thua Thien Hue. Among them, the 39-year-old one and the 27-year-old one did not have vaginas as well as uteruses; the 15-year-old one did not have vagina. I and my partners have performed endoscopic surgeries, remove a piece of colon, about 15cm, but tried to keep the arteries working to connect the uterus and vagina. On average, each surgery took from 2 to 3 hours; however, in the case of 15-year-old one who has uterus but no vagina, it was considered a difficult and complicating case, so it took almost 4 hours to perform the surgery, create the vagina as well as to maintain the function of menstruation and fertility.

What are the advantages and difficulties in deploying this technique?

Applying the technique of creating vagina by using the colon is the best solution that we have been doing research on for many years working in this field. The first advantage is that we can create a vagina with whatever length we want (10, 15 or even 20cm), the blood flow in the arteries will keep the connected part alive so it can work well. Moreover, when using the colon, the intestinal mucosa will secrete the mucus well and it also has good elasticity. In case the colon is not long enough, we have to use the small intestine instead, but it is definitely not as good as the colon. This is supposed to be the most difficult case. Fortunately, the three cases that we operated on were not that hard.

How long do they have to wait to see the “durability” after the surgeries?

For the two cases who have just had their surgeries, they were discharged from the hospital just after 6 days. The first patient who had her surgery 3 months ago has come back to the hospital to have health re-examination, and everything is fine. According to our research, the colon has very high durability. To ensure the patient’s safety, the patient can have sexual intercourse with her husband after 3 months since the surgery, on average; they still have the ability to conceive, give birth as other women do due to the fact that they all have ovaries. Many cases in the world have good health, even the ability to get pregnant and give birth.

How much does each surgery cost?

On average, each surgery costs about 30 million VND, if the patient does not have health insurance, it will increase to about 50 million VND. We have heard that there was only one doctor in Ho Chi Minh city who could use this technique at the cost of more than 150 million VND (now this doctor is overseas). Many people have also done survey in Thailand, each case would cost at least 20,000 USD (about 500-600 million VND)

For women who have this kind of defect, what point of time should we intervene?

The women with the absence of vagina are considered to suffer from Rokitansky syndrome-other organs in the girls’ bodies develop normally, apart from the genital tract. In Vietnam, there is one in 5,000 girls born suffering from this syndrome. This is not a small number. For these cases, it is best to intervene at their puberty (about 13-14 years old). At this stage, they usually have menstrual cramp. If they do not have surgeries in time, it can be dangerous to their life.

Thank you.

By Minh Van