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The pitfalls of vaginal construction
Melissa C Davies1, Sarah M Creighton, Christopher R J Woodhouse
1Academic Department of Obstetrics and Gynaecology, University College London, London, UK.
BJU International
|May 17, 2005
Summary
Complex vaginoplasty in young women often requires multiple surgeries due to complications like stenosis and fistula. This procedure remains the primary option for achieving a functional vagina in cases of severe congenital anomalies.
Area of Science:
- Reproductive Medicine
- Surgical Innovation
- Congenital Anomalies
Background:
- Complex vaginoplasty addresses severe genital tract anomalies in young women.
- These cases often involve prior pelvic surgeries and are unsuitable for less invasive treatments.
Purpose of the Study:
- To evaluate outcomes of complex vaginoplasty in young women.
- To assess complications and functional results, including menstruation and sexual activity.
Main Methods:
- Retrospective review of 15 patients (mean age 22.2 years) undergoing complex vaginoplasty (1997-2004).
- Data collected on underlying conditions, prior surgeries, operative techniques, and complications.
- Follow-up averaged 4.75 years.
Main Results:
- 14 patients had complex congenital anomalies; 11 had associated urinary/gastrointestinal issues.
- 31 vaginal procedures were performed, including ileal vaginoplasty and skin grafting.
- Common complications included stenosis (6 patients) and fistula (4 patients).
- Eight patients achieved sexual activity; seven have not attempted intercourse.
Conclusions:
- Complex vaginoplasty is associated with frequent and significant complications, often necessitating repeat surgeries.
- Despite challenges, it offers the sole option for achieving a functional vagina in this patient group.
- Increasing survival rates for congenital anomalies suggest a rising need for such complex reconstructive surgeries.