Vaginal Lengthening Procedures for Noncongenital Indications

Area of Science:

• Urogynecology
• Minimally Invasive Surgery
• Reconstructive Surgery

Background:

• Shortened vaginal length can result from iatrogenic or medical conditions.
• Management strategies range from conservative approaches to complex surgical interventions.

Purpose of the Study:

• To provide an overview of graft and flap techniques for vaginal lengthening.
• To discuss the management of shortened vaginal length with various surgical approaches.

Main Methods:

• Review of conservative and surgical management options for vaginal shortening.
• Description of surgical techniques including buccal grafts, split-thickness grafts, pudendal thigh flaps, and biologic grafts.
• Case examples illustrating management of graft-versus-host disease, iatrogenic shortening, and complex genitourinary sinus with vaginal obliteration.

Main Results:

• Successful management of vaginal adhesions and shortening using lysis and grafts.
• Effective use of split-thickness grafts for iatrogenic vaginal shortening.
• Robotics-assisted vaginal lengthening with biologic grafts for complex cases.

Conclusions:

• Iatrogenic and medical causes of vaginal shortening are common in urogynecology.
• Urogynecologists should consider adopting grafting techniques or collaborative care for vaginal lengthening procedures.