THE MALAGA FLAP FOR VAGINOPLASTY IN THE MAYER-ROKITANSKY-KUSTER-HAUSER SYNDROME - EXPERIENCE AND EARLY-TERM RESULTS

We report our experience in vaginoplasty for the treat ment of six cas es of the Mayer-Rokitansky syndrome using bilateral vulvoperineal fasc iocutaneous flaps measuring 8 to 9 x 3 cm. We consider a detailed desc ription of the operative technique, noting the modifications that we h ave introduced as our experience increased, in addition to the cosmeti c and functional results. On the other hand, the indications for using this vaginoplasty are presented. On the basis of our clinical results , the actual anatomy of the blood vessels leading to the pedicle of th e flap, and the geometric design of the vulvoperineal flap, the follow ing technical points can be made: (1) It is a secure and reliable tech nique because of well-established vascularization beneath the lateral border of the labia majora. (2) It is a straightforward method because the transposition and rotation of a vertical flap is easier than the use of more distant flaps. (3) There is a minor risk of injury to the superficial perineal neurovascular pedicle and Bartholin's gland. (4) Innervation extends into the external two-thirds of the artificial vag ina. And (5) an acceptable cosmetic and functional result is achieved without the need to use dilators, obturators, or molds.