Abstract
Background: Innovations in vaginoplasty aim at creating a cosmetically and functionally near normal vaginas with minimal morbidity. One such innovation is the use of fibrin glue to fix the graft in a neovagina. It is simple, effective, not time consuming, and leads to better hemostasis and tissue apposition. Additional use of a vacuum expandable mold can further improve the outcome. Case: A 25-year-old married woman presented with primary amenorrhea and coital difficulty. Examination revealed normal secondary sexual characters and absent vagina. Ultrasound confirmed absent uterus and vagina, and normal ovaries. With the diagnosis of Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome having been made, McIndoe vaginoplasty was planned. A split thickness skin graft was taken from the thigh. A vaginal mold was created by using sterile foam with a rubber tube in the center and covered by condom. After spreading the graft over the mold, the edges of graft were approximated using fibrin glue, instead of conventional use of sutures, and glue was applied over rest of the graft. The diameter of the mold could be decreased by creating negative pressure in the rubber tube, which helped in its easy placement in the neovagina. The mold was removed on the 7th postoperative day. Results: The cavity was inspected and the graft appeared to be taken up well. The patient was able to lead a normal sexual life. Conclusions: The use of fibrin glue with a vacuum expandable mold in vaginoplasty appears to be promising. (J GYNECOL SURG 29:265)
Published Version
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