Vaginal reconstruction with the muscle-sparing vertical rectus abdominis myocutaneous flap

Abstract

The use of the rectus abdominis myocutaneous flap in reconstruction is well documented. It can be used to fill defects in the walls of the chest, the abdomen, the groin and the perineum. In this study, details of observations on five patients who underwent vaginal reconstruction using a muscle-sparing vertical rectus abdominis myocutaneous (MS-VRAM) flap are presented. Between September 2006 and October 2007, five patients underwent vaginal reconstruction using a MS-VRAM flap. All patients had congenital absence of the vagina. All MS-VRAM flaps survived completely. No complications occurred at the donor site of abdominal wall. In the course of 2-9 month follow-ups, the patients reported satisfaction, though they were unmarried and had no regular sexual partners. This study demonstrates that a new vagina can be created from the MS-VRAM flap and that the reconstruction is reliable, with low donor-site morbidity, easier surgical technique and shorter operation time. However, the major disadvantage of this technique is the conspicuous abdominal scar.