Endocrine Abstracts

Purpose: For vaginoplasty of Rokitansky syndrome, we use oxidized regenerated cellulose instead of bio-craft that has been used in the past because it requires a less invasive and more physiological surgery. However, the mechanism of epithelialization of this procedure is still not clear. There is a report that differentiation and proliferation of the vaginal epithelium of newborn mice is promoted by administration of basic fibroblast growth factor (bFGF).

To characterize the epithelium of new vagina and to determine how it is formed, we examined the new vaginal epithelium for the presence of keratin, estrogen receptor α (ERα) and bFGF.

Methods: Four patients with Rokitnsky syndrome who underwent this operation were enrolled in this study. Patients’ consent was obtained with the approval of the ethics committee.

Samples of vaginal epithelium were removed at the time of the operation, in the reproducing phase, and after completion of epithelialization. Samples of the vaginal epithelium and bdominal skin of patients who underwent total hysterectomy were also obtained as controls with their consent.

Immunostaining of ERα, keratin 13 and keratin 14 were performed using human monoclonal antibodies. Real-time PCR of four subtypes of fibroblast growth factor receptor (FGFR; FGFR-1, FGFR-2, FGFR-3, and FGFR-4) was also performed.

Results: Immunohistochemical staining revealed that keratin 13 and ERα were expressed in normal vagina and the new vagina, while keratin 14 was expressed only in the abdominal skin.

It appeared that the expression of FGFR-1, was markedly increased in the reproducing phase and decreased after the completion of vaginal epithelialization, while there were no significant changes in the other FGFR subtypes.

Conclusion: The characterization of the new vaginal epithelium with this surgery was demonstrated to be similar to that of normal vagina. Moreover, it was suggested that FGF may be an important growth factor which promotes new vaginal epithelialization.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.