MRKH is not a condition that is heard of or spoken about often, but it does occur in some women. Diagnosis isn’t always easy, and those who are diagnosed often have many questions and concerns about what their next steps are. Drs. Miklos and Moore are specialists in MRKH diagnosis and solutions, and we have compiled a collection of the most frequently asked questions (and answers) to ease a troubled mind.
Q: What is the average age of a person diagnosed with MRKH?
Typically, a person with MRKH is diagnosed between the ages of 15 and 18 years old.
Q: What tests can be performed to confirm that a person has MRKH?
Initially, a pelvic exam can be performed to confirm diagnosis; however, additional testing is usually required. A pelvic ultrasound or MRI is done to confirm whether or not a uterus can be seen and to confirm if the patient has one or two kidneys. Additional tests, such as a blood test, may be done to confirm karyotype (female genes) and ovarian function.
Q: I don’t live near a Miklos & Moore location, but would like to get a consultation with Dr. Miklos and Dr. Moore. How do I do this?
Most of our MRKH/AIS patients do not live in the Atlanta or Los Angeles Area. Before deciding if our Laparoscopic Davydov procedure is the right one for you, please call our Patient Care Coordinator, to set up a phone consultation with Dr. Miklos and Dr. Moore. If you decide to have the surgery with the doctors, we can arrange for you to have a consultation and surgery in the same week. Our staff is very experienced in working with patients that elect to have next-day surgery. We will make sure all of your questions are answered and needs are met prior to your arrival date.
Q: How does this procedure work?
In brief, Drs. Miklos and Moore utilize the peritoneal lining of the pelvis as the lining of the new vaginal canal. They open the introitus up and this brings them into the pelvis from below and between the bladder and the rectum. Then, they pull the peritoneum down to the opening and suture this with absorbable sutures. Drs. Miklos and Moore then do a “purse-string” suture at the top of the pelvis to create the new top of the vagina.
Over a timespan that usually lasts 6-12 months, the peritoneum actually transforms, thickens, and becomes true vaginal epithelium (if you were to look under a microscope). This procedure is similar to stem cell placement. Studies have been done on sexual function, including arousal, lubrication, sensation, and orgasm, and have been found to be equivalent to matched controls with normal, developed vaginas.
Q: What are the risks of this procedure, both relating to the surgery and the anesthetic?
The surgery itself takes between 90 and 120 minutes and is completed under general anesthesia, however, Drs. Miklos and Moore work with excellent anesthesiologists and therefore, given the length of the surgery, this is a very minimal risk. Risks for this type of Neovagina surgery are actually the lowest of any abdominal approach, and probably even lower than some of the vaginal approaches, as no skin grafts are needed to be taken or used, nor any muscle flaps from the thighs, etc.
Keep in mind that any time you do the dissection for the Neovagina, there is a risk of bladder and/or bowel injury. However, it is very minimal, and even if it occurs, it can typically be repaired at the time of the surgery and the following months. Drs. Miklos and Moore have never had a bowel injury and have only had one bladder injury when performing this surgery and they have been performing it for the last decade.
Q: How successful is this procedure?
This procedure yields over a 95% success rate. It’s important to note that each patient has something to do with their own success because she will have to be vigilant in the first few months by maintaining the length and passing dilators several times a day. The patient does not have to dilate, but she does have to pass a dilator a few times daily to ensure that the vagina is not scarring down or sticking together. She typically does not have to dilate for length.
Q: How much length can be added to the vaginal canal with this procedure?
Drs. Miklos and Moore typically end up with 12 cm of length, though they do know that over time and with healing, a patient can usually use a couple of centimeters, and most patients end up with about 10 cm. This is more than adequate length however, as long as a woman has more than seven or eight centimeters, sexual function should not be affected.
There are more questions that you may have about MRKH and Neovagina creation that need answering. If this is an option you’re looking to explore, contact Drs. Miklos and Moore for a consultation today; they are experts in the procedure and will be able to soothe any nerves you may have.