Vaginal construction in children & adolescents

Steven M. Tillem, Moneer K. Hanna

Research output: Contribution to journalArticlepeer-review

Abstract

Between 1980-1996 we have constructed a vaginal cavity in 20 children and adolescents. Their abnormalities included: Mayer-Rokitansky Syndrome (6), micropenis (5), penile agenesis (3), cloacal exstrophy (3), classic bladder exstrophy (1), truehemaphrodism(1) and Testicular Feminization Syndrome (1).. We have utilized the scrotal skin in 1, urolhelium (1), sigmoid colon (6) and small bowel in (13), The skin lined vagina lost it's depth over the years and was converted to an ileal vagina. Of the 13 ileal and 6 sigmoid vaginas two developed anastomic strictures of the mucocutaneous junction, which were revised by a Y-V plasty. Excellent results were achieved when trie bowel was used for vaginal construction and 4 are now sexually active teenagers. A perineal based skin flap is incorporated to avoid a circumferential suture line and consequent stenosis of the mucocutaneous junction. We have found that ileum is the segment of choice in younger children, as it reaches the perineum easily and is of the appropriate size. However in adolescents the sigmoid colon is preferable to the ileum because of it's size and mobility. Vaginal construction using a bowel segment provides a self lubricating, esthetically superior neovagina, The pros and cons of various tissues used for vaginal construction are presented.

Original languageEnglish
Pages (from-to)163
Number of pages1
JournalBritish Journal of Urology
Volume80
Issue numberSUPPL. 2
StatePublished - 1997
Externally publishedYes

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