Modified vecchietti operation for creation of a neovagina

ABSTRACT

In the modified technique, a simple apparatus utilizing the principles of the original Vecchietti operation was used but without opening the bladder peritoneum. First opening the skin through a small Pfannenstiel incision, followed by the rectus sheath, then dissected the retropubic space without opening the peritoneum. After threading an unabsorbable thread in the olive, the Stamy needle was used to pass the threads on each side of the bladder neck and the upper ends of the threads were passed lateral to the two recti muscles and fixed on a traction apparatus on the abdomen. A total of 23 patients were operated upon. Before the operation, the mean length of the vaginal pouch was 1.7 +/- 0.45 cm and the mean length became 8.1 +/- 1.6 cm at the end of the traction after the operation. Except transient stress incontinence in one patient, no complications were recorded. The advantages of the operation were that the normal anatomy and innervation were maintained. It was an extraperitoneal approach with low incidence of complications and there was no perineal scar allowing sexual intercourse within two weeks after discharge from the hospital