YEDİ OLGUDA NÖROVASKULER PUDENDAL UYLUK FLEBİ İLE VAJİNA REKONSTRÜKSİYONU
-
Vaginal Reconstruction with Neurovascular Pudendal Thigh Flap in Seven Cases
Background:Reconstruction of the vulva, vagina and perineum is still a challenge for the plastic andreconstructive surgeons, gynecologists, pediatric surgeons, urologists and general surgeons. The majorindications for the reconstruction of the vagina are vaginal agenesis and post-oncological surgery. Manytechniques have been described for the reconstruction of this anatomical region. The neurovascular pudendalthigh flap is one of these.Material and methods:In this report we presented the results of the neurovascular pudendal thigh flap in sevenfemale patients with primary amenorrhea secondary to congenital vaginal agenesis.Results:There were no early or late complications in our series. Only hair growth was observed in three patientsbut this caused no complaints. Satisfactory functional, sensory and cosmetical results were achieved in allpatients within the post-operative six months.Conclusions:We concluded that neurovascular pudendal thigh flap is one of the most ideal techniques inreconstruction of the vagina due to its relatively simple technique, acceptable scar formation in donor area, lack ofneed for a stent in post-operative period, durable and reliable characteristics of the flap and successful functionaland cosmetical results
___
- 1. Horton CE Jr., Horton CE. Vaginal reonstruction. In
Ehrlich RM, Alter GJ (eds) Reconstructive and plastic
surgery of the external genitalia, 1st ed.
Philadelphia:W.B. Saunders, 1999: 233-235.
- 2. Ghirardini G, Segre A. Vaginal agenesis (mayer -
rokitansky - kuster - hauser syndrome): recent
etiopathogenetical and anatomical views. Clin Exp
Obstet Gynecol 1982; 9:98-102.
- 3. Karim RB, Hage JJ, Dekker JJ, Schoot CM. Evolution
of the methods of neovaginoplasty for vaginal aplasia.
Eur J Obstet Gynecol Reprod Biol 1995; 58:19-27.
- 4. Gurlek A, Monstrey S Prof S. The versatility of the
pudendal thigh fasciocutaneous flap used as an island
flap. Plast Reconstr Surg 2002; 109:402-3.
- 5. Joseph VT. Pudendal-thigh flap vaginoplasty in the
reconstruction of genital anomalies. J Pediatr Surg
1997; 32:62-5.
- 6. Oosterlinck W, Monstrey S. The pudendal thigh
fasciocutaneous flap to cover deep perineal defects,
combined with reconstruction of the posterior urethra.
BJU Int 2002; 89:133-5.
- 7. Monstrey S, Blondeel P, Van Landuyt K, Verpaele A,
Tonnard P, Matton G. The versatility of the pudendal
thigh fasciocutaneous flap used as an island flap. Plast
Reconstr Surg 2001; 107(3):719-25.
- 8. Buss JG, Lee RA. McIndoe procedure for vaginal
agenesis: results and complications. Mayo Clin Proc
1989; 64:758-61.
- 9. Hagerty RC, Vaughn TR, Lutz MH. The perineal artery
axial flap in reconstruction of the vagina. Plast
Reconstr Surg 1988; 82:344-5.
- 10. Wee JT, Joseph VT. A new technique of vaginal
reconstruction using neurovascular pudendal- thigh
flaps: a preliminary report. Plast Reconstr Surg 1989;
83:701-9.
- 11. Ralston DR, Tunney P, Orton CI, Elstein M. The use of
a tissue expander as a vaginal stent in vaginal
reconstruction. Br J Obstet Gynaecol 1995; 102:62-3.
- 12. Tamaya T, Imai A. The use of peritoneum for
vaginoplasty in 24 patients with congenital absence of
the vagina.Arch Gynecol Obstet 1991; 249:15-7.
- 13. Ashworth MF, Morton KE, Dewhurst J, Lilford RJ,
Bates RG. Vaginoplasty using amnion. Obstet Gynecol
1986; 67:443-6.
- 14. Copeland LJ, Hancock KC, Gershenson DM, Stringer
CA, Atkinson EN, Edwards CL. Gracilis
myocutaneous vaginal reconstruction concurrent with
total pelvic exenteration. Am J Obstet Gynecol 1989;
160:1095-101.
- 15. Sadove RC, Horton CE. Utilizing full-thickness skin
grafts for vaginal reconstruction. Clin Plast Surg 1988;
15:443-8.
- 16. Velidedeoðlu H, Karacaoðlan N, Bozdoðan N, Þahin
Ü, Aksoylar A, Kurtay A, Türkgüven Y. 41 Vajinal
Agenezis Olgusunun Nörovaskü
ler Pudental Thigh Flep ile Rekonstrüksiyonundan
Alýnan Sonuçlar.Yeni Týp Dergisi 1995; 12: 35-38
- 17. McCraw JB, Massey FM, Shanklin KD, Horton CE.
Vaginal reconstruction with gracilis myocutaneous
flaps. Plast Reconstr Surg 1976;58: 176-78 Ê
- 18. Lilford RJ, Johnson N, Batchelor A. A new operation
for vaginal agenesis: Construction of a neo-vagina
from a rectus abdominis musculocutaneous flap. Br. J
Obstet Gynaecol 1989; 96: 1089-90
- 19. Levy JB, Darson MF, Bite U, Kramer SA. Modified
pudendal-thigh flap for correction of penoscrotal
transposition. Urology 1997; 50:597-600.
- 20. Monstrey S, Blondeel P, Van Landuyt K, Verpaele A,
Tonnard P, Matton G. The versatility of the pudendal
thigh fasciocutaneous flap used as an island flap. Plast
Reconstr Surg 2001; 107:719-25.
- 21. Kelemen Z, Lehoczky G. Closure of severe vesicovagino-rectal
fistulas using Lehoczky´s island flap. Br
J Urol 1987; 59: 153
- 22. Gürlek A, Gherardini G, Görgü M, Erdogan B, Coban
YK, Evans GRD. The repair of multiple recto-vaginal
fistulas with the neurovascular flap
(Singapore flap): A case report. Plast Reconstr Surg
1997; 99: 2071