Primary Amenorrhea due to Mayer–Rokitansky–Küster–Hauser (MRKH) Syndrome Managed with Laparoscopic Davydov Procedure: A Case Report

Background: Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome is a congenital anomaly characterized by uterovaginal aplasia in phenotypic females with normal secondary sexual characteristics. It is the second most common cause of primary amenorrhea and may require neovagina creation for sexual function. Laparoscopic Davydov vaginoplasty uses peritoneum to line a neovaginal canal, offering favorable outcomes. Case Presentation: A 19-year-old woman presented with primary amenorrhea and normal secondary sexual characteristics (Tanner P4M4). Examination revealed a ~3-cm vaginal dimple. Imaging showed uterine agenesis with normal ovaries. Laparoscopic Davydov procedure involved creation of a tract between bladder and rectum, mobilization of peritoneal flaps, pull-through to introitus, and cuff formation. Recovery was uneventful; follow-up showed good neovaginal length and tolerance of dilators. Conclusion: Laparoscopic Davydov vaginoplasty is a safe, effective option for MRKH, achieving satisfactory anatomy and function when combined with postoperative dilator use and counseling.