NEOVAGINAL CYTOLOGY AFTER TOTAL PELVIC EXENTERATION FOR GYNECOLOGICALMALIGNANCIES

Vaginal reconstruction has become an established method to restore sex ual unction in women who have undergone ultraradical surgery and/or ir radiation for the treatment of gynecologic malignancies. Cytologic eva luation of the neovagina serves a major role in the detection of recur rent disease. The purpose of this retrospective 6-yr study (January 19 87-December 1993) was to evaluate the cytologic feat urea of vaginal s mear specimens from neovaginas constructed utilizing split-thickness s kin grafts Thirty-four vaginal smears were obtained at regular interva ls from nine women (mean age: 51 yr) who underwent total pelvic exente ration with vaginal reconstruction for recurrent malignancies of the v agina and the cervix. Anucleated, keratinizing squames were a constant finding in each smear. Over a 4-mo-6-yr postoperative period, superfi cial and intermediate squamous cells were present in the majority of h e smears and the maturation index showed a shift to the right. In two cases, a squamous cell carcinoma of the cervix recurred within the neo vagina. Knowledge of the cytologic features associated with neovaginas is important in order to distinguish normal changes from neoplastic l esions. (C) 1995 Wiley-Liss, Inc.