Archives of Gynecology and Obstetrics

, Volume 277, Issue 6, pp 551–554 | Cite as

Adaptation process of the skin graft to vaginal mucosa after McIndoe vaginoplasty

  • M. Bekerecioglu
  • O. Balat
  • M. Tercan
  • M. Karakok
  • M. G. Ugur
  • D. Isik
Original Article



There are many methods of treatment of vaginal agenesis.


In this study, patients who underwent McIndoe vaginoplasty were evaluated for development of vaginal mucosa. Vaginal pH measurements, smears, and punch biopsies were obtained from seven patients postoperatively at 3, 6, and 12 months after having McIndoe vaginoplasty.


Neovaginal smears indicated no specific data for mucosal development at the 3rd and 6th month after the operation. However, Doderlein bacilli were determined at the 12th month. Histopathological examination of punch biopsies revealed dermal and subdermal thickening at the 3rd month, partial adaptation to mucosa at 6th month, and full adaptation to mucosa at 12th month. Also normal vaginal pH levels were recorded at the 12th month.


As a result of the adaptation process, the split thickness skin graft acquired both histological and physiological characteristics of normal vaginal mucosa. Also, neovaginal epithelium was evaluated to be macroscopically similar to normal vaginal mucosa, 12 months after the operation.


Vaginoplasty Skin graft Vaginal mucosa 


  1. 1.
    Rock JA (1997) Surgery for anomalies of the mullerian ducts. In: Rock JA, Thompson JD (eds) Te Linde’s operative gynecology. 8th edn. Lippincott-Raven Publishers, Philadelphia, pp 687Google Scholar
  2. 2.
    Sadove RC, Horton CE (1988) Utilizing full-thickness skin grafts for vaginal reconstruction. Clin Plast Surg 15:443–448PubMedGoogle Scholar
  3. 3.
    Hockel M, Menke H, Germann G (2003) Vaginoplasty with split skin grafts from the scalp: optimization of the surgical treatment for vaginal agenesis. Am J Obstet Gynecol 188:1100–2PubMedCrossRefGoogle Scholar
  4. 4.
    Tercan M, Balat O, Bekerecioglu M, Atik B (2002) The use of fibrin glue in the McIndoe technique of vaginoplasty. Plast Reconstr Surg 109:706–709PubMedCrossRefGoogle Scholar
  5. 5.
    Folch M, Pigem I, Konje JC (2000) Mullerian agenesis: etiology, diagnosis, and management. Obstet Gynecol Surv 55:644–649PubMedCrossRefGoogle Scholar
  6. 6.
    Simman R, Jackson IT, Andrus L (2002) Prefabricated buccal mucosa-lined flap in an animal model that could be used for vaginal reconstruction. Plast Reconstr Surg 109:1044–1049PubMedCrossRefGoogle Scholar
  7. 7.
    Karim RB, Hage IJ, Dekker IJ, Schoot CM (1995) Evolution of the methods of neovaginoplasty for vaginal aplasia. Eur J Obstet Gynecol Reprod Biol 58:19–27PubMedCrossRefGoogle Scholar
  8. 8.
    Hockel M, Menke H, Germann G (2003) Vaginoplasty with split skin grafts from the scalp: optimization of the surgical treatment for vaginal agenesis. Am J Obstet Gynecol 188:1100–1102PubMedCrossRefGoogle Scholar
  9. 9.
    Johnson N, Batchelor A, Lilford RJ (1991) Experience with tissue expansion vaginoplasty. Br J Obstet Gynaecol 98:564–568PubMedGoogle Scholar
  10. 10.
    Johnson N, Lilford RJ, Batchelor A (1991) The free-flap vaginoplasty; a new surgical procedure for the treatment of vaginal agenesis. Br J Obstet Gynaecol 98:184–188PubMedGoogle Scholar
  11. 11.
    Yesim OG, Ozcan M (2003) Neovaginal construction with buccal mucosal grafts. Plast Reconstr Surg 111:2250–2254CrossRefGoogle Scholar
  12. 12.
    Hallberg H, Holmstrom H (2003) Vaginal construction with skin grafts and vacuum-assisted closure. Scand J Plast Reconstr Surg Hand Surg 37:97–101PubMedCrossRefGoogle Scholar
  13. 13.
    Toolenaar TA, Freundt I, Wagenvoort JH, Huikeshoven FJ, Vogel M, Jeekel H, Drogendijk AC (1993) Bacterial flora of the sigmoid neovagina. J Clin Microbiol 31:3314–3316PubMedGoogle Scholar
  14. 14.
    De Filippo RE, Yoo JJ, Atala A (2003) Engineering of vaginal tissue in vivo. Tissue Eng 9:301–306PubMedCrossRefGoogle Scholar
  15. 15.
    Seccia A, Salgarello M, Sturla M, Loreti A, Latorre S, Farallo E (2002) Neovaginal reconstruction with the modified McIndoe technique: a review of 32 cases. Ann Plast Surg 49:379–384PubMedCrossRefGoogle Scholar
  16. 16.
    Lelle RJ, Heidrenreich W, Schneider J (1990) Cytologic findings after construction of a neovagina using two surgical procedures. Surg Gynecol Obstet 170:21–24PubMedGoogle Scholar
  17. 17.
    Alessandrescu D, Peltecu GC, Buhimschi CS, Buhimschi IA (1996) Neocolpopoiesis with split-thickness skin graft as a surgical treatment of vaginal agenesis: retrospective review of 201 cases. Am J Obstet Gynecol 175:131–138PubMedCrossRefGoogle Scholar
  18. 18.
    Belleannee G, Brun JL, Trouette H, Mompart JP, Goussot JF, Brun G (1998) Cytologic findings in a neovagina created with Vecchietti’s technique for treating vaginal aplasia. Acta Cytol 42:945–948PubMedGoogle Scholar
  19. 19.
    Takashina T Takashina T, Kanda Y, Tsumura N, Hayakawa O, Tanaka S, Ito E (1988) Postoperative changes in vaginal smears after vaginal reconstruction with a free skin graft. Acta Cytol 32:109–112PubMedGoogle Scholar
  20. 20.
    Masters WH, Johnson VW (1961) The artificial vagina: anatomic, physiologic, psychosexual function. West J Surg 69:192–212PubMedGoogle Scholar
  21. 21.
    Pierce GW, Klabunde EH, O’connor GB, Long AH (1956) Changes in skin flap of a constructed vagina due to environment. Am J Surg 92:4–8PubMedCrossRefGoogle Scholar
  22. 22.
    Lepargneur JP, Rousseau V (2002) Protective role of the Doderlein flora. J Gynecol Obstet Biol Reprod 31:485–494Google Scholar
  23. 23.
    Gallup DG, Castle CA, Stock RJ (1987) Recurrent carcinoma in situ of the vagina following split thickness skin graft vaginoplasty. Gynecol Oncol 26:98–102PubMedCrossRefGoogle Scholar
  24. 24.
    Steiner E, Woernle F, Kuhn W, Beckmann K, Schmidt M, Pilch H, Knapstein PG (2002) Carcinoma of the neovagina: case report and review of the literature. Gynecol Oncol 84:171–175PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • M. Bekerecioglu
    • 1
  • O. Balat
    • 2
  • M. Tercan
    • 3
  • M. Karakok
    • 4
  • M. G. Ugur
    • 5
  • D. Isik
    • 6
  1. 1.Faculty of Medicine, Department of Plastic Reconstructive and Aesthetic SurgeryGaziantep UniversityGaziantepTurkey
  2. 2.Faculty of Medicine, Department of Obstetrics and GynecologyGaziantep UniversityGaziantepTurkey
  3. 3.Department of Plastic SurgeryHaydarpasa Training HospitalIstanbulTurkey
  4. 4.Faculty of Medicine, Department of PathologyGaziantep UniversityGaziantepTurkey
  5. 5.Department of Obstetrics and GynecologyKahramanmaras Pazarcik Government HospitalKahramanmarasTurkey
  6. 6.Department of Plastic Reconstructive and Aesthetic SurgeryGaziantep Avukat Cengiz Gokcek Government HospitalGaziantepTurkey

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