Abstract：
BACKGROUND:One of the most important criteria indicative of the longterm success of vaginal enlargement is the absence of postoperative contracture. Numerous procedures have been developed for reconstruction of an inadequate vagina. Some are technically complex techniques (myo- and fasciocutaneous flaps) with few postoperative complications of vaginal contracture, and others implement autografts with a greater tendency of tissue contraction. STUDY DESIGN:We report here a method of vaginoplasty using deepithelialized vulvar transposition flaps to enlarge the width of narrow vaginas found mainly in cases of congenital adrenogenital syndrome-associated vaginal atresia, but also in cases of acquired vaginal atresia (surgery and radiotherapy-induced). We used deepithelialized dermis from the labia majora to construct an enlarged vaginal entrance and cavity, a technique that is easy to learn and perform. RESULTS:The healing phase of this operation is free of tissue rejection, most likely because of the close embryologic relationship of the cornified, paravaginal squamous epithelium of the labia majora and the noncornified squamous epithelial lining of the lower third of the vagina. The epithelium of the graft loses its cornified layer and becomes nonhair-bearing; its cytology and histology mimic normal vaginal epithelium. Postoperative function and sexual contentment were reported to be satisfying. CONCLUSIONS:The followups of 17 patients who underwent this operation in the last 16 years show optimal cosmetic and functional results.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
Wierrani F,Grünberger Wdoi
10.1016/s1072-7515(02)01541-7keywords:
subject
Has Abstractpub_date
2003-01-01 00:00:00pages
159-62issue
1eissn
1072-7515issn
1879-1190pii
S1072-7515(02)01541-7journal_volume
196pub_type
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