V1106 USE OF AUTOLOGOUS BUCCAL MUCOSA VAGINOPLASTY IN CHILDREN: SURGICAL TECHNIQUE

Abstract

You have accessJournal of UrologyPediatrics1 Apr 2010V1106 USE OF AUTOLOGOUS BUCCAL MUCOSA VAGINOPLASTY IN CHILDREN: SURGICAL TECHNIQUE Juan Prieto, Nicol Bush, and Linda Baker Juan PrietoJuan Prieto Corpus Christi, TX More articles by this author , Nicol BushNicol Bush Dallas, TX More articles by this author , and Linda BakerLinda Baker Dallas, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2303AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Complex vaginal replacement surgeries often require donor materials such as skin grafts, myocutaneous flaps, or bowel, each with significant disadvantages. As an alternative, we present our technique using autologous buccal mucosa grafting for primary construction and secondary repair for partial or complete vaginoplasty. METHODS From 2004 to present, 20 females have presented with primary or secondary post-surgical vaginal abnormalities requiring complex vaginoplasty. Our indications for buccal mucosa vaginoplasty have included: 1) primary repair of vaginal agenesis (Mayer-Rokitansky syndrome), cloacal abnormalities, and intersex disorders, and 2) secondary postsurgical vaginal repair of vaginal stenosis or vaginal foreshortening after vaginoplasty. This video demonstrates our surgical technique in a Mayer-Rokitansky syndrome patient. RESULTS For total neovagina creation, a transverse incision is made over the mucosal prominence at the level of the expected location of the hymen. Blunt dissection and electrocautery are used to dissect between the urethra and anorectum to depth 8 cm and width 3 fingerbreadths. Bilateral buccal mucosa is harvested, prepared on the bench and sewn end to end. The graft mid-portion is secured with interrupted 4-0 chromic to the apex of the previously dissected vaginal vault. The meshed graft is then stretched and tacked into position with interrupted 4-0 chromic sutures to achieve 360 degree coverage of the entire neovaginal area. A spongy vaginal mold is left in-situ for 5-7 days. CONCLUSIONS Buccal mucosa generates a moist, hairless, nonkeratinized neovaginal mucosa with excellent color and texture matching the genital/vaginal skin. It leaves no visible surgical scars, avoids abdominal bowel surgery and has no excess mucous production. It is an ideal replacement material for primary or secondary vaginoplasty with excellent early results. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e429-e430 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Juan Prieto Corpus Christi, TX More articles by this author Nicol Bush Dallas, TX More articles by this author Linda Baker Dallas, TX More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...