Vaginal Reconstruction with an Axial Subcutaneous Pedicle Flap from the Inferior Abdominal Wall

Abstract
A new method of vaginal reconstruction is reported. In the procedure, the left inferior abdominal wall flap with the subcutaneous pedicle containing epigastric superficial blood vessels and/or the circumflex iliac superficial vessel and the external pudendal vessel and their branches is raised and passed through an immediate extraperitoneal tunnel to be the artificial vagina. The operation is straightforward, quick, and safe. Thirty consecutive patients suffering from congenital absence of vagina have been treated. All flaps in the group, which were less bulky, survived completely. The follow-up survey was carried out from 6 months to more than 4 years postoperatively. There was no occurrence of hernia after surgery. The reconstructed vaginas in all patients were clean, soft, elastic, and expansible. Married patients indicated satisfaction with their sexual life.