Neovaginal construction with buccal mucosal grafts.

Abstract

Several surgical techniques have been designed to construct a neovagina that will be satisfying in appearance, function, and feeling when the vagina is congenitally absent. However, no method has yet been approved as a perfect solution. With the aim of solving the problems with conventional methods, the authors describe a new surgical technique that is simple and safe for treating vaginal agenesis. This technique consists of creating a mucosal lining of the neovaginal cavity using multiple full-thickness buccal mucosal patch grafts. Four patients with congenital absence of the vagina treated with this technique are presented. This surgical procedure created a mucus-providing lining inside the neovagina. Selecting the donor site in the oral region resulted in an inconspicuous donor-site scar. Histologically, the neovaginal lining was confirmed as mucosal, and the cream-colored viscous fluid found in the neovaginal cavity was confirmed as mucus. At a mean follow-up period of 15 months, the neovagina remained adequate in depth and width. All of the patients were interviewed to evaluate the function of the neovagina. Each patient reported having regular sexual intercourse and that the neovagina had felt normal to their partners. The encouraging results obtained in four cases suggest that this new technique deserves further application.