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Updated: Jun 14, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Vaginoplasty in the female exstrophy population: Outcomes and complications
Raimondo M Cervellione1, Timothy Phillips, Nima Baradaran
1Division of Pediatric Urology, Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, Maryland, USA.
Insights
Vaginal stenosis affects over 30% of female bladder exstrophy patients. Vaginoplasty in adolescence or early adulthood is a successful treatment with a low complication rate.
Area of Science:
- Pediatric Urology
- Female Genital Reconstruction
- Bladder Exstrophy Management
Background:
- Vaginal stenosis is a frequent complication following surgical reconstruction for classic bladder exstrophy in infancy.
- Adolescent and adult female outcomes require specific evaluation.
Purpose of the Study:
- To determine the incidence of vaginal stenosis in female patients with classic bladder exstrophy.
- To evaluate the outcomes of vaginoplasty for vaginal stenosis in the first three decades of life.
Main Methods:
- Retrospective review of a bladder exstrophy database for female patients aged 12-30 years.
- Analysis of vaginoplasty outcomes including age at surgery, reconstruction method, complications, and re-stenosis rates.
Main Results:
- Out of 91 female patients, 29 (31.8%) underwent vaginoplasty for vaginal stenosis at a mean age of 15 years.
- Perineal flap vaginoplasty was the most common method used.
- One patient (3.4%) experienced wound complications requiring reoperation; no cases of re-stenosis were observed.
Conclusions:
- Vaginal stenosis is a common issue in adult survivors of classic bladder exstrophy reconstruction.
- Vaginoplasty is a highly effective treatment for vaginal stenosis in this population, offering good outcomes with minimal risk when performed in the second or third decade of life.
Objective:
Vaginal stenosis is a common sequela in adolescents who have undergone reconstruction for classic bladder exstrophy in infancy. We sought to determine the incidence of vaginal stenosis in our patient population and the outcome of treatment in the first three decades of life.
Patients And Methods:
An institutional review board approved bladder exstrophy database was used to identify and retrospectively review classic female bladder exstrophy patients aged 12-30 years treated at the authors' institution. Patients who underwent vaginoplasty were identified and the following outcomes were measured: age at surgery, method used for the reconstruction, complications and incidence of re-stenosis.
Results:
Ninety-one female classic bladder exstrophy patients were identified. Twenty-nine patients (31.8%) underwent vaginoplasty because of vaginal stenosis at a mean (SD) age of 15 (3) years. Twenty-four patients underwent perineal flap vaginoplasty, three posterior cut-back vaginoplasty and two YV vaginoplasty. One patient developed wound infection and dehiscence which required reoperation (3.4%). No patient experienced vaginal re-stenosis.
Conclusions:
vaginal stenosis is common after reconstruction of female classic bladder exstrophy. Vaginoplasty is highly successful in the exstrophy population when performed in the second or third decade of life with a low risk of complications.
