Home > Health Guides by Topic > Gynecology & Reproductive Health > MRKH > MRKH Guide for Teens > McIndoe Surgical Procedure MRKH:
McIndoe Surgical Procedure
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If you are reading this guide, it is possible that your gynecologist has recommended this operation because you have been diagnosed with MRKH. You may have been told that you have an incomplete vagina or vaginal agenesis. After helping you understand your diagnosis, your doctor will probably talk to you about treatment option or ways to create a vagina. Vaginal dilators must be prescribed by a doctor and are usually the first treatment option as this method does not require surgery. The McIndoe surgical procedure, may be an option if you do not get good results from using vaginal dilators.
What is a McIndoe procedure?
The McIndoe procedure is an operation that corrects vaginal agenesis by creating a vagina with a skin graft. 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. 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, your doctor will first take a skin graft (a very thin piece of skin) from your buttocks or another area of your body. It is also possible to use artificial skin instead. If you are having a skin graft your doctor may ask you to outline your bathing suit borders with a washable marker (before your surgery). This is done so that the skin graft site 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 or (small cut) at the area of the vaginal dimple (where the skin puckers in). The vaginal mold (with the skin graft attached) is placed inside this opening. While the vaginal mold is in place, the skin graft will gradually 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.
What happens after the surgery?
The vaginal mold must stay in place for about 1 week. You will remain in bed (in the hospital) during this time so that the new skin can heal. You will not be allowed to get out of 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 about a 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 should plan to be in the hospital for about 7 days. However, if you have problems such as a fever, you may need to stay in the hospital longer. Most teens who 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 be in the hospital for a while.
When is it safe to have sex?
If after examining you, your doctor tells you that your vagina as healed well, you can begin to have intercourse. This usually is the case in approximately 4-6 weeks after your surgery. Since women with vaginal agenesis have less moisture in their vagina, a vaginal lubricant such as K-Y jelly may be 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 will only remove it when you have to pass urine, have a bowel movement, shower, or have sexual intercourse. 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. In about 6 weeks, after your vagina has healed, 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 by the McIndoe procedure alone 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 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 chat page for information on our online health chat for teens with MRKH.
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’s office.
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Updated: 1/26/2010
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