Construction of a neovagina after exenteration using the vulvobulbocavernosus myocutaneous graft

Construction of a neovagina after exenterative surgery is important for the psychologic adjustment of the patient undergoing exenteration. The bulbocavernosus muscle, fat, and overlying vulvar skin have been used as a pedicle graft to create a neovagina in eight patients undergoing supralevator pelvic exenteration in the past 22 months. The vaginal length and caliber has proved to be excellent with return of normal sexual function among four women who currently have a sexual partner. This graft is easier to construct with less operative time and blood loss than the gracilis myocutaneous graft. The cosmetic results are excellent and there have been no complications.