VAGINAL RECONSTRUCTION - CRITICAL TECHNICAL PRINCIPLES

Childhood vaginal anomalies are frequently encountered, often in assoc iation with significant anorectal or urinary tract abnormalities. As a result, reconstruction poses a number of technical challenges. We mai ntain that the best results are achieved by single stage perineal reco nstruction. The primary goal of achieving a functional and cosmeticall y adequate vagina must not be at the expense of the optimal repair of associated urinary and anorectal abnormalities. In addition, since the se repairs are performed early in childhood, vaginal growth is an issu e that further limits the choice of reconstructive technique. We prese nt a series of successful vaginal reconstructions in complex cases and an outline of the principles of surgical care.