TRANSFORMATION OF THE MUCOUS MEMBRANE OF THE ARTIFICIAL VAGINA CREATED FROM THE LARGE INTESTINE
Keywords:
sigmoid colon, mucous membrane, neovagina, Mayer–Rokitansky–Küster–Hauser syndrome, pathomorphological examinationAbstract
Relevance. According to the World Health Organization (WHO), abnormalities of the female genital organs are more common in families and countries with limited resources. About 94% of severe malformations are found in low- and middle-income countries, where women often face poor nutrition and lack of access to quality health care. Despite the large number and types of surgical interventions to create a neovagina, its morphological aspects have not yet been fully studied.
Purpose: Study of morphological changes in the mucous membrane of an artificial vagina created from the sigmoid colon.
Methods: To assess the morphofunctional state of the mucous membrane of the neovagina, after 6 months of observation, biopsy material was taken from 28 patients with vaginal anomalies for histological examination. The condition of the neovagina of patients after surgery was studied using general histological methods, such as hematoxylin and eosin staining, according to the Van Gysan method, according to Weigert method, CHIC staining, and Alcian blue staining.
Results Obtained: The results of histological examination showed that the neovaginal mucosa was completely re-epithelialized and began to produce glycogen within approximately 6 months in all cases. Our study revealed that the mucous membrane of the neovagina in all cases had a flattened structure without the transverse folds characteristic of a normal vagina. This difference is due to the insufficient number of cells and venous plexuses under the mucous membrane of the neovagina. It is assumed that these differences are associated with the peculiarities of tissue architecture, vascularization and innervation of the neovagina compared to the normal vaginal wall.
Conclusions: Studying the state of the neovagina created from the sigmoid colon, assessing the structural changes in the transformation of single-layer epithelium into multilayer epithelium observed in it makes it possible to predict the survival rate of the neovagina of patients.
References
Adamyan L.V., Bobkova M.V. etc. Vaginal and pelvic aplasia Kidney dystopia - management tactics and possibilities of surgical correction malformation of the genital organs.//Russian Medical Journal Vol. 24, №. 4 (2018) P.54-60. (in Russ).
Adamyan L.V., Kulakov V.I., Khashukoeva A.Z. Developmental defects uterus and vagina. - M.: Medicine, 1998. – P. 327. (in Russ).
Kadurina T.I., Gorbunova V.N. Connective tissue dysplasia. – St. Petersburg, 2009. – P. 701. (in Russ).
Kruglyak D.A., Buralkina N.A., Ipatova M.V. and others. Aplasia of the vagina and uterus (VUVA): etiology, pathogenetic aspects and theories of defect formation (literature review) Gynecology / Vol. 20. №. 2, 2018. P.64-66. (in Russ).
Kruglyak D.A., Buralkina N.A., Ipatova M.V. and others. Mayer–Rokitansky–Küster–Hauser syndrome: modern treatment methods, psychological and social aspects (analytical review) Reproductive health of children and adolescents / Vol. 14. 3, 2018. P.58-73. (in Russ).
Negmadzhanov B. B., Mamatkulova M. D. Surgical treatment of neovaginal prolapse after sigmoid colpopoiesis // Problems of modern science and education. – 2022. – №. 2 (171). – P. 48-52. (in Russ).
Allen L, Lucco KL, Brown CM, Spritzre RF, Kives S (2010) Psychosexual and functional outcomes after creation of a neovagina with laparoscopic Davydoff in patients with vaginal agenesis. FertilSteril 94: P. 2272–2276
Imparato E, Alfei A et al.: Long-term results of sigmoid vaginoplasty in a consecutive series of 62 patients. Int Urogynecol J (2007) 18: P. 1465–1469.
Kim T. H., Shalav A., Elliman R. G. Active-oxidation of Si as the source of vapor-phase reactants in the growth of SiOx nanowires on Si // Journal of Applied Physics. – 2010. – T. 108. – №. 7.
Kinsner-Ovaskainen A. et al. A sustainable solution for the activities of the European network for surveillance of congenital anomalies: EUROCAT as part of the EU Platform on Rare Diseases Registration //European Journal of Medical Genetics. – 2018. – T. 61. – N. 9. – P. 513-517.
Koski M. E. et al. Colpocleisis for advanced pelvic organ prolapse //Urology. – 2012. – T. 80. – №. 3. –P. 542-546.
Levitt M. A., Peña A. Anorectal malformations // Orphanet journal of rare diseases. – 2007. – T. 2. – №. 1. – P. 33.
McQuillan S. K., Grover S. R. Dilation and surgical management in vaginal agenesis: a systematic review //International urogynecology journal. – 2014. – T. 25. – P. 299-311.
Morcel K. et al. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome //Orphanet journal of rare diseases. – 2007. – T. 2. – №. 1. – P. 13.
Rizzo L. et al. Urban wastewater treatment plants as hotspots for antibiotic resistant bacteria and genes spread into the environment: a review //Science of the total environment. – 2013. – T. 447. – P. 345-360.
Wu J. M. et al. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery //Obstetrics & Gynecology. – 2014. – T. 123. – №. 6. – P. 1201-1206.
Статья поступила в редакцию 25.05.2024; одобрена после рецензирования 27.05.2024; принята к публикации 29.05.2024.
The article was submitted 25.05.2023; approved after reviewing 27.05.2024; accepted for publication 29.05.2023.
Информация об авторах:
Хамидова Фарида Муиновна- доктор медицинских наук, доцент, заведующая кафедрой Патологической анатомии с курсом секционной биопсии Самаркандского государственного медицинского университета, E-mail: Хamidovaf.m.05@mail.ru, https://orcid.org/0000-0001-6084-7025.
Якубов Мунис Зокирович - Заведующий кафедрой судебной медицины Самаркандского Государственного медицинского университета, yakubovmunis@gmail.com, https://orcid.org/0000-0002-0449-7566.
Information about the authors:
Khamidova Farida Muinovna - Doctor of Medical Sciences, Associate Professor, Head of the Department of Pathological Anatomy with a course of sectional biopsy of Samarkand State Medical University, E-mail: Хamidovaf.m.05@mail.ru, https://orcid.org/0000-0001-6084-7025.
Yakubov Munis Zokirovich - Head of the Department of Forensic Medicine, Samarkand State Medical University, yakubovmunis@gmail.com, https://orcid.org/0000-0002-0449-7566.
Источники финансирования: Работа не имела специального финансирования.
Конфликт интересов: Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи.
Вклад авторов:
Хамидова Ф.М — идеологическая концепция работы, редактирование статьи;
Якубов М.З — сбор и анализ источников литературы, написание текста.
Sources of funding: The work did not receive any specific funding.
Conflict of interest: The authors declare no explicit or potential conflicts of interest associated with the publication of this article.
Contribution of the authors:
Xamidova FM — ideological concept of the work, writing the text; editing the article;
Yakubov MZ — collection and analysis of literature sources, writing the text.
