VAGINOPLASTY - COMBINATION THERAPY USING LABIA-MINORA FLAPS AND LUCITE DILATORS - PRELIMINARY-REPORT

The treatment of vaginal agenesis is varied. The combination of creati ng a vaginal cavity with local skin flaps, then progressively dilating to a functional size has been successful in the past. We describe a t echnique using tubularized labia minora vascularized flaps to create a deep vaginal pouch that is widened and elongated with lucite dilators . The new vagina has an epithelial lining of nonhair-bearing skin. Thr ee teenage girls, 2 with the Mayer-Rokitansky syndrome and 1 with mixe d gonadal dysgenesis, underwent this procedure without any postoperati ve complications. Since neither abdominal surgery nor skin grafting wa s required there were no extra scars, excessive neovaginal secretions or need for long-term splinting during the 1-year followup period. The patients have almost normal-appearing genitalia postoperatively and n eovaginas averaging 2 cm. wide and 6.3 cm. deep before dilation. We re commend this procedure as first line treatment for teenage girls with vaginal agenesis.