Vaginal Reconstruction with Pudendal Thigh Flaps

ABSTRACT

Reconstruction of vagina can be accomplished by various methods. But in most cases they require stents or dilators and the angle of vagina is unphysiologic. Donor site scars are also formidable. We used pudendal thigh flaps described by Wee and Joseph to overcome the disadvantages of the traditional techniques. We performed the bilateral use of the flap to reconstruct vagina in 6 patients with congenital viginal atresia and the unilateral use to reconstruct vaginal defect in one patient after oncologic resection. The vaginas were successfully reconstructed with either bilateral or unilateral 6 x 12 cm pudendal thigh fasciocutaneous flap based on the terminal branches of the superficial perineal artery. All 13 pudendal thigh flaps in 7 patients survived completely and the vagina was reconstructed in one stage. The flaps were sensate and the vaginal dimensions were well maintained without stents or dilators. This technique seems superior to other methods as is already known. But the donor site scars became widened in 4 patients although they were in the groin crease. There were also minimal complications such as wound dehiscence in 1 patient, prolapse of flap in 1 patient, and some hair growth in the flaps in 3 patients. We report the use of pudendal thigh flaps for vaginal reconstruction and discuss the functional and aesthetic results in this article