Vaginoplasty: combination therapy using labia minora flaps and lucite dilators--preliminary report

The treatment of vaginal agenesis is varied. The combination of creating a vaginal cavity with local skin flaps, then progressively dilating to a functional size has been successful in the past. We describe a technique using tubularized labia minora vascularized flaps to create a deep vaginal pouch that is widened and elongated with lucite dilators. The new vagina has an epithelial lining of nonhair-bearing skin. Three teenage girls, 2 with the Mayer-Rokitansky syndrome and 1 with mixed gonadal dysgenesis, underwent this procedure without any postoperative complications. Since neither abdominal surgery nor skin grafting was required there were no extra scars, excessive neovaginal secretions or need for long-term splinting during the 1-year followup period. The patients have almost normal-appearing genitalia postoperatively and neovaginas averaging 2 cm. wide and 6.3 cm. deep before dilation. We recommend this procedure as first line treatment for teenage girls with vaginal agenesis.