Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 16 , ISSUE 1 ( January-February, 2024 ) > List of Articles


Creating a Pathway for a Dead End: Horse Shoe Flap Vaginoplasty for Mayer–Rokitansy–Kuster–Hauser Syndrome: A Case Report

SR Dhanvarsha Sumaldha, G Rohini, Sai Supriya Muthyala, Anand Prasath Jayachandiran, Narayanamurthy Sundaramurthy, Surya Rao Rao Venkata Mahipathy

Keywords : Case report, Mayer–Rokitansky–Kuster–Hauser syndrome, Sexual problems, Vaginoplasty

Citation Information : Sumaldha SD, Rohini G, Muthyala SS, Jayachandiran AP, Sundaramurthy N, Mahipathy SR. Creating a Pathway for a Dead End: Horse Shoe Flap Vaginoplasty for Mayer–Rokitansy–Kuster–Hauser Syndrome: A Case Report. J South Asian Feder Obs Gynae 2024; 16 (1):54-57.

DOI: 10.5005/jp-journals-10006-2336

License: CC BY-NC 4.0

Published Online: 10-01-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Background: For a woman, the absence of a vagina makes her devoid of both sexual well-being and motherhood. Vaginal agenesis is by no means rare and is a cause of primary amenorrhea. Mayer–Rokitansky–Kuster–Hauser (MRKH) syndrome affects 1/4000–1/10,000 females. Case description: Here we report a 39-year-old female, who presented with complaints of inability to have sexual intercourse. After history and physical examination, an MRI was done showing normal abdominal organs, hypoplastic uterus, and bilateral ovaries 1 cm × 1 cm. Karyotyping showed 46XX. Horse shoe labial flap vaginoplasty was done as per the technique of Purushothaman. The postoperative period was uneventful with the flap settling well. On follow-up at 3 months, she was able to successfully use 1/4th of the dilator 3 and reported having a satisfactory sexual life with her partner. Conclusion: Horse shoe labial flap vaginoplasty uses the entire hairless skin within the labia majora to create a neovagina. Being a new technique with simplified suturing techniques and augmented blood supply, it is a more reliable method with better results.

  1. Purushothaman V. Horse shoe flap vaginoplasty—A new technique of vaginal reconstruction with labia minora flaps for primary vaginal agenesis. Br J Plast Surg 2005;58(7):934–939. DOI: 10.1016/j.bjps.2005.04.013.
  2. ACOG Committee on Adolescent Health Care. ACOG Committee Opinion No. 355: Vaginal agenesis: Diagnosis, management, and routine care. Obstet Gynecol 2006;108(6):1605–1609. DOI: 10.1097/00006250-200612000-00059.
  3. Yii NW, Niranjan NS. Lotus petal flaps in vulvo-vaginal reconstruction. Br J Plast Surg 1996;49(8):547–554. DOI: 10.1016/s0007-1226(96)90132-0.
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