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[Vaginal reconstruction with modified pudendal-thigh flap]
Yongguang Ma1, Hongsen Bi, Youchen Xia
1Department of Plastic Surgery, Peking University Third Hospital, Beijing 100191, PR China. ygma51@yahoo.com.cn
Summary
This study modified the pudendal-thigh flap for vaginal reconstruction, improving surgical outcomes and patient satisfaction in individuals with vaginal absence or transsexualism.
Area of Science:
- Plastic Surgery
- Gynecologic Surgery
- Reconstructive Surgery
Background:
- Vaginal reconstruction aims to restore anatomical and functional integrity.
- Pudendal-thigh flaps are utilized for neovagina creation.
- Optimizing flap viability and aesthetic outcomes remains a surgical challenge.
Observation:
- A modified pudendal-thigh flap technique was applied to 15 patients (13 female, 2 male) undergoing vaginal reconstruction.
- The flap design prioritized arterial perforator integrity and facilitated transfer.
- Surgical procedure involved flap elevation, pedicle management, and transfer through a prepared tunnel.
Findings:
- All flaps demonstrated successful survival with satisfactory vulvar contour.
- 14 out of 15 patients achieved primary wound healing; one rectovaginal fistula resolved spontaneously.
- Reconstructed vaginas averaged 10 cm in depth, with smooth inner walls and functional outcomes reported in two patients experiencing sexual intercourse.
Implications:
- The modified pudendal-thigh flap offers a reliable blood supply for vaginal reconstruction.
- This technique enhances surgical convenience and improves aesthetic results of the neovagina and vulva.
- Successful functional and aesthetic restoration can positively impact patient quality of life.