Vaginal reconstruction with bilateral island "extended" groin flaps: description of a personal technique

We propose a vaginal reconstruction method using two island "extended" groin flaps designed over the iliac crests and in axis with the superficial circumflex iliac arteries. After a surgical revision of the pelvic organs and dissection of the area between the bladder and the rectum, the two flaps pass, extraperitoneally by way of the abdomen, through an incision made along the lateral margin of the rectus muscle and, from before to behind, through the fibrovascular lamina lateral to the bladder, and finally are placed in the area between the bladder and the rectum, where they are sutured. The technique has been applied to one patient and allowed reconstruction of a vaginal canal with very suitable dimensions and in order to allow sexual intercourse. This seems a safe technique in terms of flap vitality because the operation is carried out extraperitoneally. Finally, the appearance of the external genitalia has not been altered and residual suture wounds have been well hidden.