THE ROLE OF RECTOSIGMOID NEOCOLPORRHAPHY

Background. Vaginoplasty for congenital vaginal atresia, a component o f the Mayer-Rokitansky-Kuster syndrome, or for gender confirmation, ma y be achieved by several techniques. This report focuses on the effica cy of rectosigmoid neocolporrhaphy (RSNC) performed either primarily o r secondarily after failure of another procedure. Methods. Sixty patie nts underwent isoperistaltic RSNC, three primarily and 57 secondarily. The indication was vaginal atresia in 1 patient and gender dysphoria in 59 patients. Results. All 60 patients survived and have a functiona l neovagina. One major complication, an anastomotic leak with colovagi nal fistula, was treated by a temporary colostomy and later reconstruc tion through a combined anterior and posterior approach. Late complica tions were reversible stomal stenosis (six patients), reversible condu it narrowing (five patients), transient rhabdomyoblastosis (one patien t), and temporary mucosal bleeding from hyperplasia (three patients). Thirty patients have regular intercourse, 12 patients have occasional intercourse, and the others feel ''whole,'' with their intact desired sexual anatomy awaiting a suitable partner. Conclusions. The number of patients seeking vaginoplasty is increasing. Primary or secondary RSN C is a safe and effective method.