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Ileocecal vaginal construction.

R A Bürger1, H Riedmiller, P G Knapstein

  • 1Department of Urology, Johannes Gutenberg University Mainz, West Germany.

American Journal of Obstetrics and Gynecology
|July 1, 1989
PubMed
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Ileocecal and cecal segments create a neovagina for complex cases, including failed reconstructions. This technique offers excellent blood supply and tensionless anastomosis, even in challenging anatomies.

Area of Science:

  • Reconstructive surgery
  • Gynecologic surgery
  • Gastrointestinal surgery

Background:

  • Vaginal reconstruction is challenging in patients with congenital anomalies or post-surgical/traumatic loss.
  • Previous reconstructive methods may fail, necessitating alternative surgical approaches.
  • Mayer-Rokitansky syndrome, male pseudohermaphroditism, and post-Wertheim-Meigs or trauma-induced vaginectomy present unique reconstructive difficulties.

Purpose of the Study:

  • To describe the operative technique for neovagina creation using ileocecal or cecal segments.
  • To evaluate the efficacy of this technique in patients with complex anatomical conditions and prior surgical failures.
  • To review and discuss current vaginal replacement techniques.

Main Methods:

  • Neovagina creation using isolated cecal or ileocecal segments in 10 patients.

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  • Utilizing the terminal ileum for lengthening the neovagina when necessary.
  • Detailed operative technique description and review of existing vaginal replacement methods.

    • Main Results:

    • Successful neovagina creation in all 10 patients, including those with prior failed reconstructions.
    • Excellent blood supply and long vascular pedicle from the ileocecal region.
    • Tensionless anastomosis achieved, even in patients with difficult anatomies, by supplementing with terminal ileum.

    Conclusions:

    • Ileocecal and cecal vaginoplasty are effective techniques for vaginal reconstruction, particularly in complex cases.
    • The technique provides robust vascularity and allows for tension-free anastomosis, improving outcomes in challenging patient populations.
    • This method offers a viable solution for patients with congenital vaginal absence or acquired loss due to trauma or oncologic surgery.