Surgical treatment for congenital absence of the vagina using tissue expansion

A modification of the Abbe-McIndoe technique for the treatment of congenital absence of the vagina, using a cylindrical tissue expander wrapped in a mesh split-thickness skin graft, instead of a rigid silicone mold, is presented. The expander was kept in place for a period of two to six months and the functional result was 100 percent in all the six patients treated. Our experience led us to change the design of the expander (cylindrical, without ring, 10X4 centimeters) and to place the valve in the inner thigh as the best site for the valve. The age range of the patients was 18 to 27 years, and the final result was good or very good in five of the six women. Only one patient has occasional dyspareunia, which does not prevent sexual intercourse.