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Construction of the Neovagina

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Female Pelvic Surgery

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Abstract

Creation of a neovagina is usually necessary in the following cases: congenital absence of the vagina, vaginal contracture and stenosis, reconstruction following neoplastic resective surgery or radiotherapy, and gender affirmation surgery. While there is no standard procedure for neovaginal reconstructive surgery, there exist many surgical and nonsurgical techniques that are often used to create the vagina. These techniques include vaginal dilation methods, the McIndoe vaginoplasty procedure with the use of split-thickness skin grafts, modified McIndoe procedures using full-thickness skin and mucosal grafts, transpositional skin graft techniques, laparoscopic techniques including the Davydov and Vecchietti operations, myocutaneous and fasciocutaneous pedicled flap surgeries, and intestinal flap surgeries. The ideal reconstructive method should provide a patent vaginal canal of adequate length, width, and texture that will allow for sexual intercourse, provide a cosmetically appealing appearance with minimal morbidity of both the recipient and donor surgical sites, and have a low incidence of overall complications. Construction of the neovagina can be very complex and challenging. Each method of repair has its advantages and disadvantages, which should be carefully weighed with the desired treatment goals as well as the surgeon’s experience with various surgical techniques.

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Authors and Affiliations

  1. Center for Urogynecology and Pelvic Reconstructive Surgery, Obstetrics, Gynecology & Women’s Health Institute, Cleveland Clinic, Cleveland, OH, USA

    Tonya N. Thomas

  2. Center for Urogynecology and Pelvic Reconstructive Surgery, Center for LGBT Care, Obstetrics, Gynecology & Women’s Health Institute, Cleveland Clinic, Cleveland, OH, USA

    Cecile A. Ferrando

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  1. System Director FPMRS, Associate Professor of Urology, The Smith Institute for Urology, Zucker School of Medicine at Hofstra/Northwell, Lake Success, NY, USA

    Farzeen Firoozi

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Thomas, T.N., Ferrando, C.A. (2020). Construction of the Neovagina. In: Firoozi, F. (eds) Female Pelvic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-28319-3_18

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