The Vecchietti procedure for surgical treatment of vaginal agenesis: comparison of laparoscopy and laparotomy

Objective: Our goal was to describe the outcomes of women with vaginal agenesis who had surgical creation of a neovagina using the Vecchietti technique over a 20-year period. We also sought to determine whether the laparoscopic approach would result in similar outcomes as laparotomy. Method: Retrospective analysis of 76 women with vaginal agenesis treated at the University of Verona Hospital between 1976 and 1996 with the Vecchietti procedure. Operative and postoperative records were reviewed, and sexual histories were obtained. Data were analyzed based on surgical approach and postoperative sexual satisfaction. Continuous data were analyzed with student's t-test, and categoric data were analyzed using Fisher's exact test. Result: Those who underwent the Vecchietti procedure with a laparoscopic approach (N = 7) had similar complication rates (0% vs. 13.0%, P = 0.59) and postoperative neovaginal depth (74.9 mm vs. 73.7 mm, P = 0.93) as those with laparotomy (N = 69). Similar proportions of women reported inadequate vaginal lubrication (28.6% vs. 17.4%, P = 0.61) and sexual satisfaction (100% vs. 78.3%) in the laparoscopy and laparotomy groups as well. Operative complications, neovaginal depth, or degree of lubrication were not good predictors of sexual satisfaction. Conclusion: Outcomes in those women who underwent the Vecchietti technique via the laparoscopic approach are comparable to those who underwent laparotomy. (C) 1999 International Federation of Gynecology and Obstetrics.