Figure 4.

Techniques for neovagina formation: (A) Histoanatomy of the vagina. A glycogenated stratified squamous epithelium lies atop a stroma forming the vaginal mucosa which is above the muscularis of uterine origin. (B) Vaginal dilation is the first line of treatment for MRKH patients (top). Surgical options are available, relying of heterotopic tissue substitutes. (C) Tissue engineering could allow for autologous vaginal mucosa grafting in MRKH patients. The “self-assembly” method is scaffold-free as fibroblasts secrete ECM components in the presence of ascorbic acid. Fibroblast-ECM sheets are fused and seeded with epithelial cells for histologically similar autologous tissue in vitro that has shown promising results in murine models. Numbers indicate procedure order. Figure created with BioRender.com.