VAGINOPLASTY WITH BILATERAL ISLANDED PUDENDAL THIGH FLAPS
AbstractBackground: Vaginal agenesis is the most common congenital deformity of female pelvis and vaginalreconstruction remains a surgical challenge. There are various surgical and non-surgical techniquesdescribed for the reconstruction of neovagina. We have used pudendal thigh flaps raised on either sideof the labia to reconstruct the vagina in 19 patients. This study is carried out in the Department ofplastic and reconstructive surgery, Hayatabad medical complex Peshawar to evaluate the functional andaesthetic outcome of vaginoplasty with bilateral pudendal thigh flaps. Methods: Vaginal reconstructionwas done with bilateral islanded pudendal thigh flaps, in 19 consecutive patients with vaginal atresia,during 5 years, from Aug 2004 to Aug 2009. The flaps were raised on either side of labia and sutured toeach other in midline to form a vaginal tube. This neo-vagina was inserted into the space between therectum and bladder and anchored to the deep pelvic tissues. Results: Out of 19, eleven patients (58%)were diagnosed with Mayer Rokitansky Kauser Hauser Syndrome and 8 (42%) with isolated vaginalatresia. The mean vaginal length and width was 9.2 and 4.3 cm respectively one year post operatively.Conclusion: This method of vaginoplasty is simple, safe, and reliable and has shown satisfactoryfunctional and cosmetic results. The reconstructed vagina has a natural angle and is sensate in its lowerpart. No postoperative stenting or dilatation is required. The donor site in the groin can be closedprimarily and the scar is well hidden in the groin crease.Keywords: Vaginoplasty, vaginal reconstruction, vaginal atresia, pudendal thigh flaps
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