Home > Health Guides by Topic > Gynecology & Reproductive Health > Vaginal Agenesis & MRKH > McIndoe Surgical Procedure McIndoe Surgical Procedure for Vaginal Agenesis:
A Guide for Teen Girls
If you are reading this guide, it is likely that your gynecologist has recommended this operation because you have MRKH or vaginal agenesis. After helping you understand your diagnosis, your doctor will probably talk to you about different ways to create a vagina. You may choose to use vaginal dilators as your first choice. Vaginal dilators are prescribed by your doctor. The McIndoe surgical procedure, is usually done if you do not get good results from using vaginal dilators. If you decide to have this operation, you will be asked to sign a consent form that gives your doctor permission to do the surgery. Your doctor will explain about any risks. If you are under age 18, a parent or guardian must also sign the surgical consent form.
What is a McIndoe procedure?
The McIndoe procedure is an operation that corrects vaginal agenesis by creating a vagina with a skin graft. The surgery is done under general anesthesia. This means that you will be in a deep sleep and will not feel any pain during the surgery.
How is a vagina created?
While you are asleep and under general anesthesia, your doctor will first take a skin graft (a very thin piece of skin) from your buttocks or another part of your body. It is also possible to use artificial skin instead of taking skin from your body. If you are having a skin graft taken from your body, before your surgery, your doctor may ask you to outline your bathing suit borders with a washable marker. This is done so that the area from where skin is taken will not be visible when you are wearing a bathing suit. The skin graft is then placed over a vaginal mold. Your doctor will create an opening by making an incision at the area of the vaginal dimple (where the skin puckers in, at the area where your vagina started to develop). The vaginal mold (with the skin graft attached) is inserted into this opening. While the vaginal mold is in place, the skin graft will naturally attach to the inside of your vagina. This process creates your vaginal opening. Later, after the skin is completely attached, the vaginal mold will be removed, leaving the newly attached skin in place.
What happens after the surgery?
You will have the vaginal mold with the skin graft inside you all the time for 1 week. You will remain in bed in the hospital during this time so that the new skin can heal. You will not be permitted to get out of bed at all. During the time you are in bed, you will also have a catheter (a tube in your bladder so that you can pass urine) and you will need to use a bed pan for bowel movements. After you have been on bed rest for one week, you will go back to the operating room to have the vaginal mold taken out.
How long will I be in the hospital?
You can expect to be in the hospital for approximately 7 days. However, if you have problems such as a fever, you may need to stay in the hospital a little bit longer. Most teens that have had this procedure say that the hardest part of the recovery process is staying in bed. Ask your doctor about services in your hospital, such as behavioral medicine (a special team of professionals who are trained at helping patients cope during their hospital stay), or activity and art therapists, to help you deal with bed rest. Many hospitals have specialists who help coordinate activities and school tutoring when patients have to stay longer than a few days.
When is it safe to have intercourse?
If after examining you, your doctor says you have healed well, you can begin to have intercourse about 4-6 weeks after your surgery. Since women with vaginal agenesis don't have the same moisture in their vagina as women without vaginal agenesis, a vaginal lubricant such as K-Y jelly is necessary for your comfort with intercourse. (Do not use oil-based lubricants such as Vaseline, since these lubricants break down the latex used in condoms causing them to tear.)
What happens when I go home from the hospital?
Before you leave the hospital, you will be taught to wear a dilator at all times for 3 months. You can only remove it when you have to pass urine, have a bowel movement, shower, or have sexual intercourse (only if your doctor tells you that your vagina is healed). After 3 months, you will have to wear the dilator only at night for 6 months, unless you are having sexual intercourse regularly. Using the dilator ensures that the new vaginal opening remains open.
Your doctor will see you often for follow-up visits to check that your new vagina is healing, and to make sure that the area where your skin graft was taken is healing well too.
What if I don't wear the dilator after surgery?
If you do not follow your doctor's instructions about using the dilators, it is possible to have problems, such as vaginal stenosis (when the newly created vagina narrows and scar tissue forms).
Will anyone be able to tell that I had this operation?
No one should be able to tell that your vagina was created with a surgical procedure. The graft site (where the skin was taken-usually the buttocks) usually fades over time, but in most cases it will leave a permanent scar.
Will anyone be able to tell that I'm wearing a dilator?
The dilator is like wearing a plastic tampon. No one can tell that the dilator is in place while you are wearing it. After your vagina has healed (in about 6 weeks), you will only have to wear the dilator at night.
What are the risks to this operation?
With any type of major surgery, there are possible problems associated with general anesthesia. Problems caused just by a McIndoe procedure are very rare. They include infection, bleeding, and possible scarring of your new vagina.
How can I prepare for surgery?
Talking to another teen that has had a McIndoe procedure for vaginal agenesis is VERY helpful. It makes a huge difference if you are well prepared and know what to expect. Talk to your doctor about the possibility of talking with another teen and visit our Health Information site on vaginal agenesis or e-mail us.
Is there anything else I should know?
When you have completed your post-op appointments after your surgery, your doctor will most likely have you return once a year to see how you are doing. If you have any concerns in the meantime, you should call your doctor.
Updated 1/4/2006
Related Information:
|
Looking for other health info? Check our A-to-Z Index. ©1999-2008 Center for Young Women's Health Children's Hospital Boston. All rights reserved.
About Us Health Guides By Topic
|
Printer Friendly
En Español
