McIndoe neovagina creation for the management of vaginal agenesis.

International Urogynecology Journal
Brian J Linder, John B Gebhart

Abstract

This video reviews technical considerations for performing a modified McIndoe vaginoplasty with skin graft. A 24-year-old female was referred for management of vaginal agenesis. She had unsuccessfully tried vaginal dilation and was interested in vaginal canal creation. A 10 × 20-cm split-thickness skin graft was harvested from the buttock and secured to a condom-covered rubber-sponge mold. The vaginal dissection was initially performed with electrocautery and sharp dissection to enter the plane between the bladder anteriorly and the rectum posteriorly. Then, blunt dissection using a finger, surgical sponges, and retractors was performed to open the space to the level of the peritoneal reflection. With the dissection completed, the graft-covered mold was inserted and secured with labial stay sutures. During the second stage of the procedure, roughly 14 days later, the mold was removed, the graft assessed, and the distal edges secured. A polyethylene mold was then used as the wound continued to heal. The patient had an uncomplicated perioperative course. She had excellent take of her skin graft, with 10 cm vaginal length and adequate vaginal caliber. Vaginoplasty with a split-thickness skin graft is an excellent surgical option f...Continue Reading

References

Sep 1, 1972·Clinical Obstetrics and Gynecology·J H Pratt
Jan 8, 2004·American Journal of Obstetrics and Gynecology·Christopher J KlingeleRaymond A Lee
Mar 16, 2007·Orphanet Journal of Rare Diseases·Karine MorcelDaniel Guerrier

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