Italian doctor uses stem cells to construct vagina

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For the first time, an Italian doctor has constructed vaginas for two women using an enzyme to break down their own vaginal cells into stem cells, which were then used to build vaginal tissue. Both women were born with a rare congenital condition marked by the absence of a vagina.

Dr. Cinzia Marchese of Rome’s Policlinico Umberto I hospital, giving details of the operations on Wednesday, told Reuters a 28-year-old woman who underwent the first operation a year ago now has a healthy vagina. “She has got married and is living a normal life,” said Marchese, whose study has been published in the journal Human Reproduction.

The second operation was carried out on a 17-year-old girl on Tuesday. Cells were taken by biopsy from the area where her vagina should grow and were used to grow mucosal tissue.

The two women had Mayer-Von Rokitansky-Kuster-Hauser Syndrome (MRKHS), which affects an estimated one in 4,000 to 5,000 female infants. Girls with this syndrome often have a normal uterus, ovaries and external secondary sexual organs such as breasts, but because they have no vagina, they cannot have sexual intercourse or give birth.

“Usually the syndrome is diagnosed when they are young and they try to have sexual intercourse for the first time and it hurts,” said Marchese.

Often embarrassed to talk about it with their parents, MRKHS patients often “live the rest of their lives with no normal sexual life, even though they are normal women with normal feelings”, she said.

So far, surgeons have been able to correct the condition by reconstructing a vagina out of grafted skin or from intestinal tissue, but the surgery is highly invasive, lengthy and painful. And it takes a long time to grow a normal mucosal wall.

Such women, if they have healthy ovaries, have been able to achieve pregnancy by artificial insemination but would then need a surrogate mother to carry the fertilized eggs and give birth.

“What we do is to take a little biopsy of 0.5 cm from the place the vagina should be,” Marchese said. They used an enzyme to break down the tissue and then let the stem cells, generate new, mucosal tissue on their own.

It took about 15 days to get a thick enough layer to transplant into the patients, Marchese said.

Marchese, a professor of clinical pathology and biotechnology, studied the use of stem cells to build sheets of skin in vitro to provide skin grafts for burn victims at Harvard Medical School with the technique’s pioneer, Howard Green.

“When I came back to Italy I modified this technique for mucosal vagina tissue,” she said, adding that its success could be good news for women with cancer and other vaginal disorders.

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