iDentistry The Journal identistry_may_aug2019 | Page 21

The Journal
Discussion
Mullerian agenesis is a common anomaly
noticed in females during adolescent age. It
poses as psychological and social burden on
the family. Also, it prevents the female to lead a
normal reproductive life. Mullerian agenesis is
a l s o
k n o w n
a s
Mayer–Rokitansky–Küster–Hauser syndrome
(MRKH). It generally involves the upper vagina,
cervix and uterus but may involves renal and
[10]
the skeletal system.
A number of non-surgical and surgical
procedures have been advised for treatment.
The non surgical procedures aim at dilating the
vagina. The Frank’s technique and Ingram
methods constitute the nonsurgical approach.
Surgical procedures include McIndoe
technique, Bowel Vaginoplasty, Davydov
technique and Vecchietti operation. Out of them
McIndoe procedure has stood against all the
odds as has come out as a primary treatment
[11]
choice of the gynaecologists.
Various materials can be used to fabricate the
vaginal stent. They are required to be retained
at the surgical site for approximately 6 months.
Moreover, they are advised to be continued use
if female is not engaging into regular and
healthy sexual intercourse, as in the event of its
non-placement may lead to scar formation,
ultimately leading to the loss of neovagina so
created.
Conclusion
The heat cure acrylic resin has proved to be a
good and reliable option to be used as surgical
stent for carrying the split thickness skin graft
and maintaining the patency of the neovagina. It
can be easily obtained from any Prosthodontics
clinician. It is a simple, quick, and cost-effective
technique to fabricate vaginal stent to prevent
contracture without any significant residual
harmful effects.
In the Mc-Indoe procedure a vaginal stent made
up of acrylic is wrapped around with a
membrane and inserted into neovagina to
maintain the patency of the vagina so created. A
number of options like amnion silicone and split
thickness skin graft are available. The allogenic
amnion graft maybe associated with some
hypersensitivity reaction and materials like
silicone may invoke some allergic reactions. An
autogenous split thickness skin graft obtained
from non aesthetic areas does not have such
complications.[12] In this case split thickness
skin graft was obtained from the medial aspect
of thighs. The material which can be used in the
vaginal cavity includes self-cure acrylic resin,
heat cured acrylic resin. The heat cure resin
benefits with less residual monomer content,
better stability. All these features make it the
[13,14]
treatment of choice.
21
Vol. 15
No. 2
May-Aug 2019