외음회음 근막피부피판을 이용한 선천성 질결여증의 재건례Reconstruction of Congenital Absence of Vagina using Vulvoperineal Fasciocutaneous Flap: A Case Report
- Other Titles
- Reconstruction of Congenital Absence of Vagina using Vulvoperineal Fasciocutaneous Flap: A Case Report
- Authors
- 김미선; 김철한; 이용석; 강상규; 탁민성
- Issue Date
- 2010
- Publisher
- 대한성형외과학회
- Keywords
- Vaginal agenesis; Vulvoperineal fasciocutaneous flap; Vaginal agenesis; Vulvoperineal fasciocutaneous flap
- Citation
- Archives of Plastic Surgery, v.37, no.6, pp 831 - 834
- Pages
- 4
- Journal Title
- Archives of Plastic Surgery
- Volume
- 37
- Number
- 6
- Start Page
- 831
- End Page
- 834
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/18210
- ISSN
- 2234-6163
2234-6171
- Abstract
- Purpose: Congenital absence of the vagina is a rare congenital condition. It occurs as a result of Mullerian duct aplasia or complete androgen insensitivity syndrome. The reconstructive modality includes skin graft, use of intestine and various methods of flap. We report a patient who underwent vulvoperineal fasciocutaneous flap to reconstruct congenital absence of the vagina, while the external genitalia and ovaries are normal.
Methods: A 26 - year - old woman presented with vaginal agenesis. Under general anesthesia, a U - shaped incision was made between the urethral meatus and the anus. The new vaginal pocket was created up to the level of the peritoneal reflection between the urinary structures and the rectum. Next, the vulvoperineal fasciocutaneous flaps were designed in a rectangular fashion. Flap elevation was begun at the lateral margin which the adductor longus fascia was incised and elevated, and the superficial perineal neurovascular pedicle was invested by the fascial layer. The medial border was then elevated. A subcutaneous tunnel was created beneath the inferior of the labia to rotate the flaps. The left vulvoperineal flap was rotated counterclockwise and the right was rotated clockwise. The neovaginal pouch was formed by approximating the medial and lateral borders. The tubed neovagina was then transposed into the cavity.
Results: At 3 weeks, the vaginal canal remained supple. After 6 weeks, the physical examination showed normal - appearing labia majora and perineum with a adequate vaginal depth. A year after the operation, the patient had a 7 cm vagina of sufficient width with no evidence of contractures or fibrous scar formation. The patient was sexually active without difficulty.
Conclusion: Although many methods were described for reconstruction of vaginal absence, there is not a method yet to be approved as a perfect solution. We used the vulvoperineal fasciocutaneous flap to reconstruct a neovagina. This method had a following merits: a single-stage procedure, excellent flap reliability, the potential for normal function, minimal donor site morbidity and no need for subsequent dilatation, stents, or obturators. We thought that this operation has a good anatomic and functional results for reconstruction of the vagina.
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Collections - College of Medicine > Department of Plastic Surgery > 1. Journal Articles
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