Insights into the assembly of the neovaginal microbiota in Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome patients

Na Chen, Lilan Hao, Zhe Zhang, Chenglu Qin, Zhuye Jie, Hongxin Pan, Jiali Duan, Xincheng Huang, Yunhong Zhang, Hongqin Gao, Ruike Lu, Tianshu Sun, Hua Yang, Jinqiu Shi, Maolian Liang, Jianbin Guo, Qianqian Gao, Xiaoyue Zhao, Zhiyuan Dou, Liang XiaoShaoqiao Zhang, Xin Jin, Xun Xu, Huanming Yang, Jian Wang, Huijue Jia, Tao Zhang, Karsten Kristiansen, Chen Chen, Lan Zhu*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

4 Downloads (Pure)

Abstract

Neovaginas are surgically constructed to correct uterovaginal agenesis in women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome or as part of gender-affirming surgery for transfeminine individuals. Understanding the assembly of the neovaginal microbiota is crucial for guiding its management. To address this, we conducted a longitudinal study on MRKH patients following laparoscopic peritoneal vaginoplasty. Our findings reveal that the early microbial assemblage exhibited stochastic characteristics, accompanied with a notable bloom of Enterococcus faecalis and genital Mycoplasmas. While both the pre-surgery dimple microbiota and the fecal microbiota constituted the primary species pool, the neovaginal microbiota developed into a microbiota that resembled that of a normal vagina at 6–12 months post-surgery, albeit with a bacterial vaginosis (BV)-like structure. By 2–4 years post-surgery, the neovaginal microbiota had further evolved into a structure closely resembling with the homeostatic pre-surgery dimple microbiota. This concords with the development of the squamous epithelium in the neovagina and highlights the pivotal roles of progressive selective forces imposed by the evolving neovaginal environment and the colonization tropism of vaginal species. Notably, we observed that strains of Lactobacillus crispatus colonizing the neovagina primarily originated from the dimple. Since L. crispatus is generally associated with vaginal health, this finding suggests potential avenues for future research to promote its colonization.

Original languageEnglish
Article number7808
JournalNature Communications
Volume15
Issue number1
Number of pages15
ISSN2041-1723
DOIs
Publication statusPublished - 2024

Bibliographical note

Publisher Copyright:
© The Author(s) 2024.

Cite this