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International braz j urol

On-line version ISSN 1677-6119

Int. braz j urol. vol.43 no.6 Rio de Janeiro Nov./Dec. 2017

http://dx.doi.org/10.1590/s1677-5538.ibju.2016.0259 

Video Section

Full-thickness skin mesh graft vaginoplasty: a skin sparing technique

Guilherme Lang Motta1 

Patric Machado Tavares1 

Gabriel Veber Moisés da Silva1 

Milton Berger1 

Brasil Silva Neto1 

Tiago Elias Rosito1 

1Departamento de Urologia do Hospital das Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, RS, Brasil

ABSTRACT

Introduction:

The ideal vaginoplasty method should promote good cosmetic and functional results with low morbidity. We describe a new technique for congenital vaginal agenesis using a full-thickness perforated skin graft.

Materials and Methods:

We report an 18 year old patient with vaginal agenesis (Morris syndrome) that undergone a modified version of McIndoe vaginoplasty.

Patient is set in a low lithotomy position and lateral traction sutures are placed in labia and a 16Fr urethral catheter inserted. An inverted “V”-shaped incision is made in the mucosal plaque below the urethra. Blunt dissection in a cephalic posterior direction forms a space between the rectum and urethra. Special care is taken to avoid rectal tear during this maneuver. A full-thickness skin graft is removed from the lower abdomen measuring 12.0×6.0cm as an aesthetic abdominoplasty. The fat tissue is removed, remaining epidermis and dermis and the graft is perforated, allowing a great surface increase. After suturing over a mold, the graft is fixed in the created space. The donor site is closed with intradermal transversal suture.

Results:

From January 2009 to August 2015, seven patients diagnosed with vaginal agenesis underwent this technique. There were no major complications or need for blood transfusions. At the six-month follow-up, all patients reported satisfactory sexual intercourse. There were no significant complications at donor site or neovagina that needed surgical intervention.

Conclusion:

Vaginal reconstruction using the perforated graft is viable with excellent functional results. Applying this modification, we yielded the good results of a classic McIndoe technique with lower donor site morbidity.

ARTICLE INFO

Available at: http://www.intbrazjurol.com.br/video-section/20160259-motta_et_al/

Int Braz J Urol. 2017; 43 (Video #17): 1193-1193

Published as Ahead of Print: February 01, 2017

Received: May 02, 2016; Accepted: October 07, 2016

Correspondence address: Guilherme Lang Motta, Departamento de Urologia, Hospital das Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Eça de Queiroz St. 194 / 205, Porto Alegre, RS, 90670-020, Brasil. Telephone: + 55 51 9655-8626 E-mail: glangmotta@hcpa.edu.br

Creative Commons License This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.