Teenager born without a vagina has one crafted out of FISH SKIN

Teenager born without a vagina has one crafted out of FISH SKIN in a pioneering and ‘simple’ operation developed to treat her genetic disorder

  • Brazilian surgeons operated on a 17-year-old with a genetic disorder 
  • Her condition meant she was born without a vagina or womb but with a vulva
  • The doctors used the skin of a tilapia fish to help construct a vaginal canal
  • The same team were the first to ever perform the operation last year 

A teenager born without a vagina has had one successfully sculpted for her out of fish skin.

The pioneering operation meant the 17-year-old could have a normal sex life but is not believed to have made her fertile.

First visiting doctors because she had never had a period, the unidentified teenager was then diagnosed with a genetic disorder which had left her without a vaginal canal.

The fish skin operation was used for the first time by the same Brazilian medics in 2018 on a 23-year-old, and the first trans patient had it done earlier this year at 35.

Professor Leonardo Bezerra, who led the team of medics at the Federal University of Ceará in Brazil, pioneered the operation and claims it is ‘simple, safe and effective’

Doctors at the university hospital of the Federal University of Ceará in the north-east of Brazil performed the operation and filmed it for a scientific journal.

The graphic footage shows the surgeons making an incision where the vagina should be and inserting the fish skin wrapped around a plastic rod.

Led by Professor Leonardo Bezerra, a pioneer of the procedure, the team operated because their patient was diagnosed with Mayer-Rokitansky-Kuster-Hauser syndrome.

This is a genetic disorder affecting about one in 4,500 girls (0.045 per cent of births) which leaves them without a vagina or uterus.

They usually have a normal vulva – the outside of the genitals – but are missing parts of their reproductive system. This patient had normal ovaries but no womb.

Professor Bezerra and the team wrote in a journal: ‘The procedure offered this patient an anatomic and functional vagina by means of a simple, safe, easy, effective, quick, and minimally invasive procedure.’

They used the skin of a tilapia fish, which is one of the most popular seafoods in the US and is cheap to buy.

After the fish was caught it was skinned and the skin descaled and sterilised using chemicals and radiation in a laboratory.

In their video footage the scientists should the whole process from the fish being caught (pictured). They choose to use tilapia fish which are cheap and easy to find

The fish are skinned and the skin sent off to a lab to be sterilised. Tilapia are a popular seafood and the skin works well for the operation because cells in it work like human stem cells

The fish skin is sterilised with chemicals and radiation to avoid smells or infection

The skin was then wrapped around a plastic mould which was inserted into the vagina where it prevented the newly created passage from collapsing and helped it to hold its shape

Tilapia fish skin releases growth factors that transform the membrane into the patient’s tissue

WHAT IS MAYER ROKITANSKY KUSTER HAUSER?

Rokitansky Syndrome, or MRKH (Mayer Rokitansky Küster Hauser), is a congenital abnormality characterised by the absence of the vagina, womb and cervix.

Women suffering from the condition will have normally functioning ovaries, so will experience the normal signs of puberty – but will not have periods or be able to conceive.

The external genatalia are completely normal which is why MRKH isn’t usually discovered until women are in their teenage years.

Rokitansky Syndrome, or MRKH (Mayer Rokitansky Küster Hauser), is a congenital abnormality characterised by the absence of the vagina, womb and cervix

Many women are able to create a vaginal canal using dilation treatment, which uses cylinder shaped dilators of different sizes to stretch the muscles.

However, if this is unsuccessful then surgery will be used to stretch the vaginal canal.

Following treatment women are able to have intercourse and can have their eggs removed and fertilised to be used in surrogacy. However, those without ovaries won’t ever be able to have children because they don’t produce any eggs.

It affects one in 5,000 live female births, according to an 1985 article in the Journal of Reproductive Medicine. 

Source: Centre for Disorders of Reproductive Development & Adolescent  

During the operation the scientists cut a 3cm (1inch) hole in the woman’s groin, wrapped the fish skin around an acrylic mould and inserted it into the wound.

Cells on the fish skin – which is inserted with the internal side against the flesh – act like human stem cells and encourage the wound to heal similarly to normal vaginal tissue.

The mould was kept in by stitches for nine days while the skin was partly absorbed by the body, then removed and replaced with a larger one for a month.

This piece of plastic forces the vagina to hold its shape and stops it collapsing or healing wrongly.

The woman was told to keep it in every night until she was able to have sex normally.

After six months her newly formed vaginal canal was between 8cm and 9cm deep (3-3.5inches) and heralded a success by the surgeons.

This is about the same size as a normal vagina – the organs are able to stretch and expand when a woman is aroused.

The teenager is still believed to be unable to carry children of her own because the procedure is only able to restore the vagina, not the womb.

Professor Bezarra and his colleagues published their report in the journal Fertility and Sterility.

WHY IS FISH SKIN USED IN VAGINAL-RECONSTRUCTION SURGERY?

Surgeons at the Assis Chateaubriand Maternity School, Brazil, have performed vaginal reconstruction surgery using fish skin in women born without a cervix, uterus or ovaries. 

Before being used, the fish skin undergoes a special cleaning and sterilisation process followed by radiation exposure to kill any viruses.

This removes all the skin’s scales and odour, leaving behind a light-coloured gel dressing that can be stored for up to two years in refrigerated, sterile packaging.

Tilapia fish skin is used in the surgery

Why is the fish-skin method used?

The ‘fish-skin method’ is considered less invasive than the traditional technique of creating a vaginal canal using skin grafts from patients’ groins.

Dr Leonardo Bezerra, from the Assis Chateaubriand Maternity School, said: ‘This procedure can be time consuming and painful as the patient needs to recover from a large incision which leaves a scar that can be unsightly and stigmatising.

‘There is also the possibility of discomfort with the reconstructed tissue.’ 

The fish-skin surgery also has a faster recovery rate with no visible scars, or risks of rejection or infections. 

Patients are typically able to walk after around 12 days, with the mould being replaced with silicone or a sponge for comfort.

Traditional surgery requires patients to spend weeks in hospital and essentially relearn how to walk.  

What does the procedure involve? 

Dr Bezerra said: ‘To make the “new vagina” we insert a vagina shaped acrylic mould, lined with the skin of tilapia, into the space created between the bladder and the rectum. 

‘The device remains there for 10 days to prevent the walls from closing.

‘During this period the skin of the tilapia is absorbed, and the cells and growth factors released by the membrane transforms, like stem cells, into the patient’s tissue cells.

‘Finally, the patient’s body completely incorporates the tilapia skin becoming biocompatible with it. 

‘The fish skin stimulates cellular growth and the formation of blood vessels and creates a new canal equal to that of an actual vagina.’

Why are tilapia fish used?

Tilapia fish are readily available in Brazil’s rivers and farms.

Their skin, which is typically thrown away, contains large amounts of moisture and is rich in collagen, which promotes healing.

It is also disease resistant and as strong as human skin. 

Tilapia skin has previously been used to heal more than 200 severe-burn victims without the use of gauzes that have to be changed regularly.  

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