Skip to main content

Advertisement

Log in

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

  • Original Article
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

There are many methods of treatment of vaginal agenesis.

Methods

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.

Results

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.

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  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 687

    Google Scholar 

  2. Sadove RC, Horton CE (1988) Utilizing full-thickness skin grafts for vaginal reconstruction. Clin Plast Surg 15:443–448

    PubMed  CAS  Google Scholar 

  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 188:1100–2

    Article  PubMed  Google Scholar 

  4. Tercan M, Balat O, Bekerecioglu M, Atik B (2002) The use of fibrin glue in the McIndoe technique of vaginoplasty. Plast Reconstr Surg 109:706–709

    Article  PubMed  Google Scholar 

  5. Folch M, Pigem I, Konje JC (2000) Mullerian agenesis: etiology, diagnosis, and management. Obstet Gynecol Surv 55:644–649

    Article  PubMed  CAS  Google Scholar 

  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 109:1044–1049

    Article  PubMed  Google Scholar 

  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 58:19–27

    Article  PubMed  CAS  Google Scholar 

  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 188:1100–1102

    Article  PubMed  Google Scholar 

  9. Johnson N, Batchelor A, Lilford RJ (1991) Experience with tissue expansion vaginoplasty. Br J Obstet Gynaecol 98:564–568

    PubMed  CAS  Google Scholar 

  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 98:184–188

    PubMed  CAS  Google Scholar 

  11. Yesim OG, Ozcan M (2003) Neovaginal construction with buccal mucosal grafts. Plast Reconstr Surg 111:2250–2254

    Article  Google Scholar 

  12. Hallberg H, Holmstrom H (2003) Vaginal construction with skin grafts and vacuum-assisted closure. Scand J Plast Reconstr Surg Hand Surg 37:97–101

    Article  PubMed  Google Scholar 

  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 31:3314–3316

    PubMed  CAS  Google Scholar 

  14. De Filippo RE, Yoo JJ, Atala A (2003) Engineering of vaginal tissue in vivo. Tissue Eng 9:301–306

    Article  PubMed  Google Scholar 

  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 49:379–384

    Article  PubMed  Google Scholar 

  16. Lelle RJ, Heidrenreich W, Schneider J (1990) Cytologic findings after construction of a neovagina using two surgical procedures. Surg Gynecol Obstet 170:21–24

    PubMed  CAS  Google Scholar 

  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 175:131–138

    Article  PubMed  CAS  Google Scholar 

  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 42:945–948

    PubMed  CAS  Google Scholar 

  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 32:109–112

    PubMed  CAS  Google Scholar 

  20. Masters WH, Johnson VW (1961) The artificial vagina: anatomic, physiologic, psychosexual function. West J Surg 69:192–212

    PubMed  CAS  Google Scholar 

  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 92:4–8

    Article  PubMed  CAS  Google Scholar 

  22. Lepargneur JP, Rousseau V (2002) Protective role of the Doderlein flora. J Gynecol Obstet Biol Reprod 31:485–494

    CAS  Google Scholar 

  23. Gallup DG, Castle CA, Stock RJ (1987) Recurrent carcinoma in situ of the vagina following split thickness skin graft vaginoplasty. Gynecol Oncol 26:98–102

    Article  PubMed  CAS  Google Scholar 

  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 84:171–175

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to D. Isik.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bekerecioglu, M., Balat, O., Tercan, M. et al. Adaptation process of the skin graft to vaginal mucosa after McIndoe vaginoplasty. Arch Gynecol Obstet 277, 551–554 (2008). https://doi.org/10.1007/s00404-007-0403-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-007-0403-8

Keywords

Navigation