Correction of congenital abnormalities of the vagina and perineum

Techniques used for vaginoplasty in patients with congenital anomalies are described. They include simple cutback, inlay of a perineal flap, perineal pullthrough, abdominal-perineal pullthrough, and the use of a free skin graft. When the clitoris is enlarged, clitoroplasty should be performed instead of clitoridectomy. The technique should vary according to the size of the phallus. Labia minora can be constructed from excess skin of the clitoris. Labioscrotal tissue can be advanced posteriorly to provide a more normal appearing vulva. These various reconstructive procedures can be performed either simultaneously or in stages depending on the complexity of the case and the age of the patient.