Objective: The aim of the present prospective study was to compare the effects of postoperative predominant traction and predominant distension on penetration and sexual satisfaction among women undergoing LAB-V and their partners. Methods: Eighteen women with vaginal aplasia were included in the study. Sexual satisfaction was measured using a visual analogue scale from zero to 100 and divided into 10 compartments, with 100 representing maximum satisfaction and 0 representing no satisfaction. The patients were randomly allocated to either the predominant distension group (PD) or the predominant traction group (PT) Results: The operative procedure was the same for both groups Postoperative care consisted of preventing infection and controlled traction and distension in each group but at different levels. In the PD group, the balloon was distended at 5 mL/day to a maximum of 40 mL reached on the seventh postoperative day. The catheter was then removed the following day. Traction was performed at a rate of 1 cm per day. In the PT group, traction was done daily using the catheter to the level of patient tolerance (maximum 3 cm) and controlled distension at a rate of 3 mL every other day. Counter traction was applied in both groups every 20–30 minutes during the first 6 hours after the daily increase in traction force. Upward massage of the upper thigh and inward massage of perineal skin were also done to relieve the pressure exerted by the distension and traction. The length and width of the vagina were measured by a specially designed measurement piece, graded in centimeters (0–20) with two ball ends, the smaller being 2 cm and the larger being 4 cm. Conclusion: increasing traction or distension is effective and safe, although increasing distension can lead to rupture of the Foley catheter balloon. Women in the PD group experienced less postoperative pain and less dyspareunia than women in the PT group.

Objective: The aim of the present prospective study was to compare the effects of postoperative predominant traction and predominant distension on penetration and sexual satisfaction among women undergoing LAB-V and their partners. Methods: Eighteen women with vaginal aplasia were included in the study. Sexual satisfaction was measured using a visual analogue scale from zero to 100 and divided into 10 compartments, with 100 representing maximum satisfaction and 0 representing no satisfaction. The patients were randomly allocated to either the predominant distension group (PD) or the predominant traction group (PT) Results: The operative procedure was the same for both groups Postoperative care consisted of preventing infection and controlled traction and distension in each group but at different levels. In the PD group, the balloon was distended at 5 mL/day to a maximum of 40 mL reached on the seventh postoperative day. The catheter was then removed the following day. Traction was performed at a rate of 1 cm per day. In the PT group, traction was done daily using the catheter to the level of patient tolerance (maximum 3 cm) and controlled distension at a rate of 3 mL every other day. Counter traction was applied in both groups every 20–30 minutes during the first 6 hours after the daily increase in traction force. Upward massage of the upper thigh and inward massage of perineal skin were also done to relieve the pressure exerted by the distension and traction. The length and width of the vagina were measured by a specially designed measurement piece, graded in centimeters (0–20) with two ball ends, the smaller being 2 cm and the larger being 4 cm. Conclusion: increasing traction or distension is effective and safe, although increasing distension can lead to rupture of the Foley catheter balloon. Women in the PD group experienced less postoperative pain and less dyspareunia than women in the PT group.

Objective: The aim of the present prospective study was to compare the effects of postoperative predominant traction and predominant distension on penetration and sexual satisfaction among women undergoing LAB-V and their partners. Methods: Eighteen women with vaginal aplasia were included in the study. Sexual satisfaction was measured using a visual analogue scale from zero to 100 and divided into 10 compartments, with 100 representing maximum satisfaction and 0 representing no satisfaction. The patients were randomly allocated to either the predominant distension group (PD) or the predominant traction group (PT) Results: The operative procedure was the same for both groups Postoperative care consisted of preventing infection and controlled traction and distension in each group but at different levels. In the PD group, the balloon was distended at 5 mL/day to a maximum of 40 mL reached on the seventh postoperative day. The catheter was then removed the following day. Traction was performed at a rate of 1 cm per day. In the PT group, traction was done daily using the catheter to the level of patient tolerance (maximum 3 cm) and controlled distension at a rate of 3 mL every other day. Counter traction was applied in both groups every 20–30 minutes during the first 6 hours after the daily increase in traction force. Upward massage of the upper thigh and inward massage of perineal skin were also done to relieve the pressure exerted by the distension and traction. The length and width of the vagina were measured by a specially designed measurement piece, graded in centimeters (0–20) with two ball ends, the smaller being 2 cm and the larger being 4 cm. Conclusion: increasing traction or distension is effective and safe, although increasing distension can lead to rupture of the Foley catheter balloon. Women in the PD group experienced less postoperative pain and less dyspareunia than women in the PT group.

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.

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.

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.

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.

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.

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.

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 6x 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.