Engineered vaginal organs, derived from the patient’s own cells, achieve normal structural and functional performance over eight years of follow-up, according to a study published online April 11 in The Lancet.
Atlántida M. Raya-Rivera, M.D., from the Wake Forest University School of Medicine in Winston-Salem, N.C., and colleagues obtained a vulvar biopsy of autologous tissue from four consecutive patients with congenital vaginal aplasia due to Mayer-Rokitansky-Küster-Hauser syndrome.
Tissue was cultured, expanded, and seeded (epithelial and muscle cells) onto biodegradable scaffolds. Organs were constructed and matured in an incubator. A perineal approach to surgically implant these organs was used.
The researchers observed no long-term postoperative surgical complications over eight years of follow-up. Serial biopsies, performed yearly, showed a tri-layered structure, consisting of an epithelial cell-lined lumen surrounded by matrix and muscle, with expected components of vaginal tissue present.
The presence of phenotypically normal smooth muscle and epithelia was confirmed with immunohistochemical analysis. Responses to the Female Sexual Function Index questionnaire showed normal ranges in all areas tested, including desire, arousal, lubrication, orgasm, satisfaction, and painless intercourse.
“Vaginal organs, engineered from the patient’s own cells and implanted, showed normal structural and functional variables with a follow-up of up to eight years,” the authors write. “These technologies could be useful in patients requiring vaginal reconstruction.”