Abstract We studied the feasibility of performing balloon vaginoplasty (BV) with conventional laparoscopic instruments through 2 modified techniques aiming at providing BV for open use. Three of 6 cases with vaginal aplasia were offered modified laparoscopically assisted balloon vaginoplasty (LAB-V) and the other 3 cases underwent modified retropubic balloon vaginoplasty (RBV). We measured operative time, complications, anatomical outcomes, functional outcomes, and re-intervention rates. Modified RBV and LAB-V were performed successfully in the 6 cases within 9-12 and 29-38 min, respectively. The neovagina depths were 8-10 and 9-12 cm, respectively. Anterior rectal wall needle puncture was encountered in 1 case of LAB-V group and posterior urethral wall puncture in an abnormally dilated urethra in 1 case of the RBV group; both cases passed uneventfully. Intercourse was initiated after removal of all catheters. The neovagina was a cosmetically appealing mimic to nature and stained with iodine up to its apex. It was feasible to perform balloon vaginoplasty operations without specialized instrument sets with comparable outcomes.

Abstract We studied the feasibility of performing balloon vaginoplasty (BV) with conventional laparoscopic instruments through 2 modified techniques aiming at providing BV for open use. Three of 6 cases with vaginal aplasia were offered modified laparoscopically assisted balloon vaginoplasty (LAB-V) and the other 3 cases underwent modified retropubic balloon vaginoplasty (RBV). We measured operative time, complications, anatomical outcomes, functional outcomes, and re-intervention rates. Modified RBV and LAB-V were performed successfully in the 6 cases within 9-12 and 29-38 min, respectively. The neovagina depths were 8-10 and 9-12 cm, respectively. Anterior rectal wall needle puncture was encountered in 1 case of LAB-V group and posterior urethral wall puncture in an abnormally dilated urethra in 1 case of the RBV group; both cases passed uneventfully. Intercourse was initiated after removal of all catheters. The neovagina was a cosmetically appealing mimic to nature and stained with iodine up to its apex. It was feasible to perform balloon vaginoplasty operations without specialized instrument sets with comparable outcomes.

Abstract We studied the operative and functional outcomes of combined retropubic balloon vaginoplasty and laparoscopic canalization (RBV-LC) for treatment of cervicovaginal aplasia. The RBV-LC procedure was performed successfully in 4 cases of cervicovaginal aplasia within 35-40 minutes primary operative time. Cystoscopy was performed to ensure bladder and urethral integrity. Endoscopically monitored canalization with laparoscopic canalization is a feasible, effective, less invasive way for management of cervicovaginal aplasia

OBJECTIVE: To study the operative, anatomic, and functional outcome of tactile cold scissor metroplasty (TCSM) as a backup method for hysteroscopic metroplasty. DESIGN: Case series with description of the technique. SETTING: Assiut University Women's Health Center. PATIENT(S): Three cases with failed hysteroscopic metroplasty out of 127 cases with uterine septa scheduled for hysteroscopic resection. INTERVENTION(S): The TCSM procedure was performed in three cases under direct laparoscopic monitoring. MAIN OUTCOME MEASURE(S): Operative time, complications, hysteroscopic appearance of the cavity, reproductive outcome, and reintervention rates. RESULTS: The TCSM procedure was performed successfully in the three cases with a short total operative time (10-12 minutes). Subsequent office hysteroscopic appearance was satisfactory. Patients were then followed up for a period of time ranging from 3 to 28 months. One case had a successful pregnancy outcome, one has an ongoing pregnancy, and the last one did not get pregnant so far. CONCLUSION(S): Tactile cold scissor metroplasty is a useful, safe, and effective backup procedure for hysteroscopic metroplasty. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

OBJECTIVE: To study the operative, anatomic, and functional outcome of tactile cold scissor metroplasty (TCSM) as a backup method for hysteroscopic metroplasty. DESIGN: Case series with description of the technique. SETTING: Assiut University Women's Health Center. PATIENT(S): Three cases with failed hysteroscopic metroplasty out of 127 cases with uterine septa scheduled for hysteroscopic resection. INTERVENTION(S): The TCSM procedure was performed in three cases under direct laparoscopic monitoring. MAIN OUTCOME MEASURE(S): Operative time, complications, hysteroscopic appearance of the cavity, reproductive outcome, and reintervention rates. RESULTS: The TCSM procedure was performed successfully in the three cases with a short total operative time (10-12 minutes). Subsequent office hysteroscopic appearance was satisfactory. Patients were then followed up for a period of time ranging from 3 to 28 months. One case had a successful pregnancy outcome, one has an ongoing pregnancy, and the last one did not get pregnant so far. CONCLUSION(S): Tactile cold scissor metroplasty is a useful, safe, and effective backup procedure for hysteroscopic metroplasty. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

OBJECTIVE: To study the operative, anatomic, and functional outcome of tactile cold scissor metroplasty (TCSM) as a backup method for hysteroscopic metroplasty. DESIGN: Case series with description of the technique. SETTING: Assiut University Women's Health Center. PATIENT(S): Three cases with failed hysteroscopic metroplasty out of 127 cases with uterine septa scheduled for hysteroscopic resection. INTERVENTION(S): The TCSM procedure was performed in three cases under direct laparoscopic monitoring. MAIN OUTCOME MEASURE(S): Operative time, complications, hysteroscopic appearance of the cavity, reproductive outcome, and reintervention rates. RESULTS: The TCSM procedure was performed successfully in the three cases with a short total operative time (10-12 minutes). Subsequent office hysteroscopic appearance was satisfactory. Patients were then followed up for a period of time ranging from 3 to 28 months. One case had a successful pregnancy outcome, one has an ongoing pregnancy, and the last one did not get pregnant so far. CONCLUSION(S): Tactile cold scissor metroplasty is a useful, safe, and effective backup procedure for hysteroscopic metroplasty. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

OBJECTIVE: To study the operative, anatomic, and functional outcome of tactile cold scissor metroplasty (TCSM) as a backup method for hysteroscopic metroplasty. DESIGN: Case series with description of the technique. SETTING: Assiut University Women's Health Center. PATIENT(S): Three cases with failed hysteroscopic metroplasty out of 127 cases with uterine septa scheduled for hysteroscopic resection. INTERVENTION(S): The TCSM procedure was performed in three cases under direct laparoscopic monitoring. MAIN OUTCOME MEASURE(S): Operative time, complications, hysteroscopic appearance of the cavity, reproductive outcome, and reintervention rates. RESULTS: The TCSM procedure was performed successfully in the three cases with a short total operative time (10-12 minutes). Subsequent office hysteroscopic appearance was satisfactory. Patients were then followed up for a period of time ranging from 3 to 28 months. One case had a successful pregnancy outcome, one has an ongoing pregnancy, and the last one did not get pregnant so far. CONCLUSION(S): Tactile cold scissor metroplasty is a useful, safe, and effective backup procedure for hysteroscopic metroplasty. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

OBJECTIVE: To study the operative, anatomic, and functional outcome of tactile cold scissor metroplasty (TCSM) as a backup method for hysteroscopic metroplasty. DESIGN: Case series with description of the technique. SETTING: Assiut University Women's Health Center. PATIENT(S): Three cases with failed hysteroscopic metroplasty out of 127 cases with uterine septa scheduled for hysteroscopic resection. INTERVENTION(S): The TCSM procedure was performed in three cases under direct laparoscopic monitoring. MAIN OUTCOME MEASURE(S): Operative time, complications, hysteroscopic appearance of the cavity, reproductive outcome, and reintervention rates. RESULTS: The TCSM procedure was performed successfully in the three cases with a short total operative time (10-12 minutes). Subsequent office hysteroscopic appearance was satisfactory. Patients were then followed up for a period of time ranging from 3 to 28 months. One case had a successful pregnancy outcome, one has an ongoing pregnancy, and the last one did not get pregnant so far. CONCLUSION(S): Tactile cold scissor metroplasty is a useful, safe, and effective backup procedure for hysteroscopic metroplasty. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

OBJECTIVE: To study the operative, anatomic, and functional outcome of tactile cold scissor metroplasty (TCSM) as a backup method for hysteroscopic metroplasty. DESIGN: Case series with description of the technique. SETTING: Assiut University Women's Health Center. PATIENT(S): Three cases with failed hysteroscopic metroplasty out of 127 cases with uterine septa scheduled for hysteroscopic resection. INTERVENTION(S): The TCSM procedure was performed in three cases under direct laparoscopic monitoring. MAIN OUTCOME MEASURE(S): Operative time, complications, hysteroscopic appearance of the cavity, reproductive outcome, and reintervention rates. RESULTS: The TCSM procedure was performed successfully in the three cases with a short total operative time (10-12 minutes). Subsequent office hysteroscopic appearance was satisfactory. Patients were then followed up for a period of time ranging from 3 to 28 months. One case had a successful pregnancy outcome, one has an ongoing pregnancy, and the last one did not get pregnant so far. CONCLUSION(S): Tactile cold scissor metroplasty is a useful, safe, and effective backup procedure for hysteroscopic metroplasty. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Abstract OBJECTIVE: To study feasibility, safety, and anatomic and functional outcomes of endoscopically monitored canalization for treatment of congenital cervical atresia. DESIGN: Case series with description of the technique. SETTING: Assiut University Women's Health Center. PATIENT(S): Five with congenital cervical atresia, two of them with associated vaginal aplasia. INTERVENTION(S): The three cases with isolated cervical atresia underwent laparoscopic canalization under vaginoscopic monitoring (LC-VM). The two cases with associated vaginal aplasia underwent laparoscopic canalization under tactile monitoring (LC-TM). Cystoscopy was done for all cases to ensure bladder and urethral integrity. MAIN OUTCOME MEASURE(S): Operative time, complication rate, menstrual pattern, and reintervention rate. RESULT(S): The LC-VM procedure was performed successfully in three cases within 20-25 minutes. The two cases with associated vaginal aplasia underwent LC-TM; one them was successful and the other was complicated with bladder puncture. Follow-up ranged from 3 to 36 months, and all had regular menstruation. CONCLUSION(S): Laparoscopic canalization under vaginoscopic monitoring is a simple, effective, and minimally invasive way of management of isolated cervical atresia. However it seems not to be the ideal technique and needs further refinements for treatment of cervical atresia associated with vaginal aplasia.