Reconstruction of vaginal agenesis with pudendal thigh flaps thinned with liposuction

Abstract

The aim of this study is to describe a technique for and data from vaginoplasty surgeries performed using a pudendal thigh flap (PTF) thinned with liposuction. A total of six patients diagnosed with Müllerian agenesis underwent vaginoplasty procedures using this technique between January 2009 and April 2012. The age range of the patients was 19-24 years. In the first stage, the subcutaneous fat tissue under the planned skin flap islands was thinned with liposuction. After 3 months, the second stage of the procedure was carried out and the PTFs were elevated. Complications such as infection, dehiscence of the suture line and haematoma were not observed in any of the patients. Although a partial flap loss was observed at the distal aspect of a flap in one patient, total healing was achieved through debridement and local wound care. Mean tissue flap thickness was found to be thinner, and adequate vaginal depth was achieved in all patients on average 13 months following surgery. We are of the opinion that PTFs thinned with liposuction enable both a thinner tissue flap and a vaginal reconstruction that more closely resembles natural anatomy.