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Related Experiment Videos

Vaginal construction in children

S M Tillem1, J A Stock, M K Hanna

  • 1Department of Urology, Long Island Jewish Medical Center and Schneider Children's Hospital, New Hyde Park, New York, USA.

The Journal of Urology
|June 17, 1998
PubMed
Summary
This summary is machine-generated.

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Vaginal construction using bowel segments offers excellent cosmetic results and minimal complications. Ileum is preferred for younger patients, while sigmoid colon suits adolescents, providing a self-lubricating neovagina without routine dilation.

Area of Science:

  • Reconstructive surgery
  • Pediatric surgery
  • Gynecologic surgery

Background:

  • Vaginal construction is a complex procedure for various congenital conditions.
  • Choosing the optimal graft material is crucial for successful outcomes.
  • Previous methods had limitations regarding lubrication and dilation requirements.

Purpose of the Study:

  • To evaluate the outcomes of vaginal construction using different isolated bowel segments in pediatric and adolescent patients.
  • To compare the efficacy and complication rates of ileum, sigmoid colon, bladder mucosa, and scrotal skin grafts.
  • To determine the preferred graft material based on patient age and specific diagnosis.

Main Methods:

  • Retrospective review of 21 vaginal constructions in 20 patients (ages 1-21) between 1980 and 1996.

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  • Graft materials included ileum (13), sigmoid colon (6), bladder mucosa (1), and scrotal skin (1).
  • Diagnoses comprised Mayer-Rokitansky syndrome, micropenis, cloacal exstrophy, penile agenesis, and others.

    • Main Results:

    • Intestinal vaginoplasty (ileum and sigmoid) demonstrated excellent cosmetic results, self-lubrication, and no need for routine dilation.
    • Bladder mucosa grafts yielded good results with periodic dilation.
    • Scrotal skin grafts led to loss of depth, requiring conversion to ileal grafts; stenosis occurred in one sigmoid and one ileal case, treated with Y-V plasty.

    Conclusions:

    • Vaginal construction with isolated bowel segments is a viable option with excellent outcomes and low morbidity.
    • Ileum is recommended for younger patients, and sigmoid colon for adolescents.
    • This technique provides a cosmetic, self-lubricating neovagina with low failure and revision rates, eliminating the need for routine dilation.