Sexual Function Following Bowel Vaginoplasty
- 1 June 2006
- journal article
- Published by Wolters Kluwer Health in Journal of Urology
- Vol. 175 (6), 2283-2286
- https://doi.org/10.1016/s0022-5347(06)00337-5
Abstract
We review our 23-year experience with bowel vaginoplasty, with particular attention to postoperative quality of life and sexual function. We reviewed the records of 57 patients who underwent bowel replacement vaginoplasty between 1980 and 2004. A total of 42 patients had the Mayer-Rokitansky syndrome, of whom 6 had varying forms of intersexuality, 6 had undergone surgery for pelvic malignancy, 1 had aphallia, 1 had cloacal exstrophy and 1 was the survivor of a conjoined twin separation. Replacement vaginoplasty was done using sigmoid colon in 39 patients, ileum in 9 and cecum in 9. Followup ranged from 18 months to 24 years, with a mean of 8.8 years. Outcome was evaluated by retrospective chart review, and the FSDQ, a validated, IRB approved instrument, was used to evaluate postoperative sexual function. Among the 57 patients postoperative sexual function was evaluated in 44, 9 were lost to followup and 4 were considered too young for evaluation. Of the 44 patients 36 responded to the FSDQ, 6 refused and 2 were unable to complete the questionnaire adequately. Of the 36 patients who responded 15 were married and 31 were sexually active. On a scale of 0 to 5, 28 patients (78%) reported sexual desire, 33% sexual arousal, 33% sexual confidence and 28 (78%) sexual satisfaction. In addition, 20 patients (56%) reported frequent orgasms, 8 (22%) occasional orgasms and 8 (22%) no orgasms. A total of 32 patients (89%) reported adequate lubrication for intercourse and 2 reported dyspareunia. Two of the 36 patients performed home dilation and required estrogen suppositories. A total of 34 patients used home douching and 20 required pads for mucus production. It appears that isolated bowel segments provided excellent tissue for vaginal replacement. For technical reasons we believe that colonic segments, particularly sigmoid, are preferable to small bowel. Sexual function following bowel vaginoplasty appears to be adequate and durable.Keywords
This publication has 13 references indexed in Scilit:
- Sexuality after sigmoid colpopoiesis in patients with Mayer Rokitansky Kuster Hauser SyndromeFertility and Sterility, 2003
- Vaginal reconstruction utilizing sigmoid colon: Complications and long-term resultsJournal of Pediatric Surgery, 2002
- The Vecchietti procedure for surgical treatment of vaginal agenesis: comparison of laparoscopy and laparotomyInternational Journal of Gynecology & Obstetrics, 1999
- Vaginal Replacement in ChildrenJournal of Urology, 1992
- Intestinal vaginoplasty for congenital absence of the vaginaJournal of Pediatric Surgery, 1992
- Vaginal constructionUrology, 1987
- The bicycle seat stool in the treatment of vaginal agenesis and stenosis: A preliminary reportAmerican Journal of Obstetrics and Gynecology, 1981
- Sigmoidovaginostomy: a new method of obtaining satisfactory vaginal depthAmerican Journal of Obstetrics and Gynecology, 1961
- The formation of an artificial vagina without operationAmerican Journal of Obstetrics and Gynecology, 1938
- An Operation for the Cure of Congenital Absence of the VaginaBJOG: An International Journal of Obstetrics and Gynaecology, 1938