LABIAL SKIN-FLAP VAGINOPLASTY USING TISSUE EXPANDERS

In severe vaginal malformations, when the distance between the upper v aginal pouch and perineum is too long (6 cm or more), reconstruction o f the vagina can be performed by colonic interposition or by long cuta neous flaps obtained by the tissue expansion technique. Two female ado lescents were treated using expanded labial skin flaps. Dissection and anastomosis between the vaginal remnant and cutaneous tube was perfor med by the transtrigonal approach. Results were satisfactory at 2.5-ye ar follow-up. In our opinion, expanded labial skin-flap vaginoplasty h as three main advantages: (1) it permits the construction of a large, soft, well-vascularized neovagina using non-hair-bearing labial skin; (2) it obviates postoperative dilations and prevents delayed stricture s; and (3) a transtrigonal approach permits an easy vaginal dissection and a careful, tension-free anastomosis.