Triple flap vaginoplasty for agenesis of the vagina

Abstract

Various procedures have been described for the creation of neovagina. McIndoe operation is gold standard for vaginoplasty in which split thick skin graft is used for lining the neovagina. However the rate of contraction of the graft is very high. We have used labia minora flaps along with the third flap created from suburethral tissue for lining the neovaginal space in 17 patients with good results. The method was used in 17 patients. After creation of neovaginal space three flaps were raised - two labia minora flaps and the third flap from suburethral tissue. The flaps were inturned and lined the neovaginal space. If whole space was not lined with flaps, supplementary grafting was used to cover the unlined space. Thirteen patients came for follow up out of whom in one patient the labia minora flap necrosed and patient developed contracture of the vagina. In all other patients the result was satisfactory. There was no need of added lubrication during sex in any of the patients. A three flap method of vaginoplasty in agenesis of the vagina has been described with good result.