Ann Coloproctol.  2020 Jun;36(3):198-203. 10.3393/ac.2018.10.30.

Double Pedicle Artery Rotation Sigmoid Vaginoplasty for Vaginal Aplasia Management

• Handaya AY
• Setyawan N
• Pangastuti N
• M
• Barmawi A
• Sofii I
• Rahman MN
• Setyawati IA
• Hafiq HM

• KMID: 2504435
• DOI: http://doi.org/10.3393/ac.2018.10.30

Abstract

Sigmoid vaginoplasty has been popular for neovagina reconstruction in vaginal aplasia. The most common surgical complication was vaginal stenosis caused by inadequate vascularization and tension because of graft length. Therefore, ischemia ensued and disrupted wound healing. The selection of double pedicle artery rotation sigmoid vaginoplasty is expected to reduce this problem. Five patients from April to December 2016 were diagnosed with vaginal aplasia; 4 had history of neovagina stenosis. These patients underwent sigmoid vaginoplasty with double pedicle artery rotation. No complications occurred during or after the procedure. Assessment postsurgery was conducted at 1 year. These results suggest that double pedicle artery rotation sigmoid vaginoplasty is a safe and acceptable technique for management of vaginal aplasia. The procedure decreased tension inside vascular pedicles as a result of maintaining abundant vascularization supply. Consequently, this procedure could avert graft necrosis, leakage, and severe stenosis. All of the patients exhibited regular menstrual cycle and satisfactory sexual activity. The outcomes were excellent with remarkable anatomical and functional results.

Keyword

Gynecologic surgical procedures; Disorders of sex development; Vaginal aplasia; Rotation; Wound healing