Pudendal-thigh Fasciocutaneous Flaps for Vaginal Reconstruction in a Melanoma Patient

Abstract

Malignant melanoma of the vagina is a rare and aggressive gynecological tumor. Radical surgery, including vaginectomy, vulvectomy, bilateral inguinal lymph node dissection, and maybe total urethrectomy is usually recommended to improve the survival rate of the patients. Vaginal reconstruction is an effective method of management of the wound resulting from oncologic resections and can preserve the sexual function. The pudendal-thigh flap is a sensate and reliable fasciocutaneous flap for vaginal reconstruction. A 62-year-old patient presented with malignant melanoma over the vulva, urethra and vagina orifice. After radical surgery, she underwent vaginal reconstruction using pudendal-thigh flaps (Singapore flap). Bilateral pudendal-thigh flaps were used to resurface the defect over the perineum and sutured together to form the outer third vagina. Half a year after the surgery, the patient present effective vulva and vaginal contour without local recurrence or distant metastasis.