In a medical first, doctors in the US have successfully implanted laboratory-grown vaginas into four teenage girls suffering from a rare birth defect, with feel and function comparable to that of a natural organ.
The girls have gained full sexual function after scientists engineered and implanted the organs created from the patients' own cells.
They were born with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome, a rare genetic condition in which the vagina and uterus are underdeveloped or absent.
"This pilot study is the first to demonstrate that vaginal organs can be constructed in the lab and used successfully in humans," said lead researcher Anthony Atala, director of Wake Forest Baptist Medical Center's Institute for Regenerative Medicine.
"This may represent a new option for patients who require vaginal reconstructive surgeries. In addition, this study is one more example of how regenerative medicine strategies can be applied to a variety of tissues and organs," said Atala.
The treatment could also potentially be applied to patients with vaginal cancer or injuries, researchers said.
The girls were between 13 and 18 years old at the time of the surgeries, which were performed between June 2005 and October 2008.
Data from annual follow-up visits show that even up to eight years after surgeries, the organs had normal function.
"Tissue biopsies, MRI scans and internal exams using magnification all showed that the engineered vaginas were similar in makeup and function to native tissue, said Atlantida-Raya Rivera, lead author and director of the HIMFG Tissue Engineering Laboratory at the MRKH in Mexico City, where the surgeries were performed.
In addition, the patients' responses to a Female Sexual Function Index questionnaire showed they had normal sexual function after the treatment, including desire and pain-free intercourse.
The organ structures were engineered using muscle and epithelial cells (the cells that line the body's cavities) from a small biopsy of each patient's external genitals.
The cells were extracted from the tissues, expanded and then placed on a biodegradable material that was hand-sewn into a vagina-like shape. These scaffolds were tailor-made to fit each patient.
About five to six weeks after the biopsy, surgeons created a canal in the patient's pelvis and sutured the scaffold to reproductive structures.
Previous laboratory and clinical research in Atala's lab has shown that once cell-seeded scaffolds are implanted in the body, nerves and blood vessels form and the cells expand and form tissue.
At the same time the scaffolding material is being absorbed by the body, the cells lay down materials to form a permanent support structure - gradually replacing the engineered scaffold with a new organ.
The advance was described in the journal Lancet.
