Association of the rectovestibular fistula with MRKH Syndrome and the paradigm shift in the management in view of the future uterine transplant

Yogesh Kumar Sarin

doi:10.47338/jns.v9.551

Authors

Yogesh Kumar Sarin Lady Hardinge Medical College, New Delhi http://orcid.org/0000-0002-6671-4319

DOI:

https://doi.org/10.47338/jns.v9.551

Keywords:

Rectovestibular fistula, Vaginal atresia, Cervicovaginal atresia, MRKH Syndrome, Vaginoplasty, Bowel vaginoplasty, Ecchietti vaginoplasty, Uterine transplantation, VCUA classification, ESHRE/ESGE classification, AFC classification, Krickenbeck classification

Abstract

Uterine transplantation in Mayer-Rokitansky-Küster-Hauser (MRKH) patients with absolute uterine function infertility have added a new dimension and paradigm shift in the management of females born with rectovestibular fistula coexisting with vaginal agenesis. The author reviewed the relevant literature of this rare association, the popular and practical classifications of genital malformations that the gynecologists use, the different vaginal reconstruction techniques, and try to know what shall serve best in this small cohort of these patients lest they wish to go for uterine transplantation in future.

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Author Biography

Yogesh Kumar Sarin, Lady Hardinge Medical College, New Delhi

Dr. Yogesh Kumar Sarin,

MBBS, MS, DNB, MCh, MBA, FAIS, FIMSA, FICS, FAMS, FFNF, FAIP

Dr. Yogesh Kumar Sarin did his graduation and post-graduation in Surgery in Christian Medical College, Ludhiana. He was trained in Paediatric Surgery in Jaipur. He later acquired MBA in health care administration from the prestigious faculty of Management Studies, University of Delhi. He worked as Director Professor & Head of Department of Paediatric Surgery in Maulana Azad Medical College (MAMC) for 22 years (1998 to 2020) and Medical Superintendent and officiating Dean, MAMC during 2015-16. He is presently posted as Director Professor & Head of Department of Paediatric Surgery in Lady Hardinge Medical College, New Delhi sinced last 3 months. His special areas of interests are Paediatric Urology, Paediatric Surgical Oncology, and Neonatal Surgery. Besides being an accomplished academician (with total teaching experience of nearly 33 years) and astute administrator, he is a skilled paediatric surgeon with many firsts to his credit. At the age of 33 years, he had successfully separated ischiopagus tetrapus conjoined twins.

Among the many Fellowships that has been conferred upon him, the notable include WHO Fellowship (2001-02) and Commonwealth Fellowship (2003) that helped him to get trained in traumatology in Westmead Hospital, Sydney and in Paediatric Laparoscopic Surgery in St. John's Hospital, Leeds and Westminster Hospital, London respectively. He did Pediatric Surgical Oncology Short Fellowship in St. Jude’s Research Cancer Institute, Memphis (USA) in 2008. He has been conferred Fellowships by many prestigious Academies and Professional bodies such as Association of Indian Surgeons (FAIS; 1996), International Medical Science Academy, International College of Surgeons (Indian Section) (FIMSA; 1998), International College of Surgeons, Indian Section (FICS-Pediatric Surgery; 1998), National Academy of Medical Sciences (India) (FAMS- Pediatric Surgery; 2007), National Neonatology Forum (FNNF; 2017), and Indian Academy of Pediatrics (FIAP; 2019). He was conferred honorary membership of South Africa Children’s Cancer Study Group (SACCSG) in 2009. He was conferred Delhi State Award for Doctors for year 2012-13.

He has been visiting Professor to many universities/ teaching hospitals in India and abroad including Nelson R Mandela School of Medicine, KwaZulu-Natal University, and Red Cross War Memorial Children’s Hospital, Cape town, South Africa in 2009, Boston Children’s Hospital, Boston, USA in 2010, Children Hospital and the Institute of Child Health, Lahore, Pakistan in 2013 and 2015, and Dhaka Shishu (Children’s) Hospital, Dhaka, Bangladesh in 2017 and 2015. He had been an observer in Department of Urology, the Hospital for Sick Children (Sickkids), Toronto in 2014.

He has participated in/ supervised 47 research projects/ thesis and had been part of one multi-site research project with extramural funding.

He is credited to 280 publications in indexed national and international scientific journals with more than 1000 citations with h-index of 14 and i10-index of 35 (many of them in national and international textbooks). He has contributed many chapters in books and is presently editing a multi-author book on Pediatric Surgery.

He is also associated with publication of many scientific journals. Besides being reviewer for many medical journals, he is presently Emaritus editor-in-chief of international ‘Journal of Neonatal Surgery’ and editorial board member of Indian Journal of Pediatrics (IJP), Global Journal of Medical Sciences; Pediatric Health, Medicine and Therapeutics; World Journal of Clinical Pediatrics; Open Pediatrics Medicine journal; Frontiers in Surgery, Wudpecker Journal of Educational Research, Advances in Surgical Sciences, Journal of Indian Medical Association (JIMA), Journal of Pediatrics and Neonatal Care and Pediatric Hematology Oncology. He has served on editorial board of three other journals, namely, Indian Journal of Surgery, Indian Pediatrics and Journal of Indian association of Pediatric Surgeons.

He has been a faculty in many scientific conferences and continuing medical education programs in India and abroad and presented more than 250 free papers/ CME lectures. He has been awarded many medals, and honors including IAPS-Ethicon Teacher Travelling Fellowship (2000), IPSO best poster award in Auckland, New Zealand (2011), IJP Travelling Professor Fellowship (2012), Avantika Dhanwantri Sewa Samman’ by NGO Avantika Saikripa Sewa Sansthan (2007), Bhagirathi Award by NGO Bhagirathi Samajik Saanskritik Manch (2011), Shri Santosh Sharma Award 2015 by NGO Santosh Sharma Trust (2016), Rejoice AYUSH Promotion Award 2019 for Yoga by Rejoice Health Foundation (2019) and Bharat ke Anmol Ratan-2019 (Lifetime Achievement Award by Tejasvi Astitva Foundation

He has organized many local and National Conferences/ CME programs. He has been very active in proceedings of Medical Council of India (MCI), National Board of Examinations, Indian Council of Medical Research (ICMR) and Council of Scientific & Industrial Research (CSIR). He has been a member of the 3-member Board of Specialty in Pediatric Surgery by Medical Council of India (MCI) to suggest changes in curriculum in 2010 and was member of postgraduate (super-specialty) committee of MCI in 2013. He has served member of Advisory Committee of CSIR for Shanti Swarup Bhatnagar (SSB) Prize for Science & Technology in Medical Sciences in the years 2013 and 2016. He has been member of ICMR Project Review Committee for the Task Force Project on Descriptive Epidemiology of Childhood injuries since 2013 till date.

He has been an active member of more than 20 national and international scientific bodies and associations. He has played a very long inning on IAPS in different capacities since 1997. He was Secretary-cum treasurer of IAPS in 2005-07. As Secretary IAPS, he was responsible for creation of many sections/ chapters of IAPS, consolidation of different IAPS funds and drafting of revised constitution. He was singularly responsible for the creation of Delhi Chapter of IAPS in 1999. He served as executive member and later Secretary cum treasurer of Delhi Chapter of IAPS. He has served as the Secretary cum treasurer of Paediatric Urology Chapter of IAPS. He had been Chairperson of Basic Research Section of IAPS. He had been also executive member of Pediatric Endoscopic society of India (PESI-IAPS).

He had been executive member of Delhi Chapter of IAP for the years 2011, 2016 and 2018. He has served as Treasurer and Joint Secretary, Indian Child Abuse, Neglect, and Child Labor (ICANCL) Group of IAP in the year 2015-16 and its Chairperson for Delhi-NCR during 2018-19. He is presently Convener of Spina Bifida Foundation- India Delhi/ NCR region and executive member of Delhi Chapter of IAP.

He has been an active member of NNF since 1998 and in the year 2000, he was nominated as IAPS nominee to have better coordination with IAPS and NNF.

He has been organising 3-4-day long Pediatric Surgery Annual Update since 2008 (12 years in a row) that is attended by as many as 50-120 MCh/ DNB students for which no registration fee has been ever charged; subsidized accommodation is provided. About 40 faculty members from India and abroad assemble every year in MAMC New Delhi to teach the students. The stawlarts who have graced these updates include notable faculty from India and abroad.

Last not but the least, he has been associated with charitable voluntary work and NGOs such as Indian Alliance for Child Rights and Udaan that works for rehabilitation of spastic children. He has organised many free operative camps in far flung areas such as Port Blair, Ujjain. He has been also an avid Yoga practitioner and has special interest in horticulture and landscaping. He recently did a Course on Health Promotion through Ayurveda and Yoga conducted by Indian Red Cross Society, New Delhi (fity hours program) in collaboration with Central Council of Research in Ayurveda and Sidha and Morarji Desai Institute of Yoga.

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