Background: A patient with congenital vaginal agenesis was unsuccessfu
l in the use of dilation to create a vaginal orifice and rejected the
option of a buttock graft. Case: Two tissue expanders were introduced
beneath the labia majora bilaterally and slowly expanded over 4 weeks.
Redundant labial tissue was advanced as a bipedicle flap to line the
neovagina created intraoperatively. Postoperative stent placement and
dilation resulted in a vaginal canal lined by full-thickness mucosa ex
ceeding 8 cm in depth. Conclusion: A modified method of tissue expansi
on vaginoplasty using a bipedicle flap is an option for the surgical c
reation of a vaginal orifice.