title: Free microvascular transfer of the vermiform appendix and colon for creation of a uterovaginal fistula: a new technique for cervicovaginal reconstruction.
abstract: OBJECTIVE
  To report a new technique for creating a uterovaginal fistula in a patient with vaginal dysgenesis, an atretic cervix, and a functional endometrium.
  
  
  METHODS
  Case report.
  
  
  METHODS
  University tertiary care hospital.
  
  
  METHODS
  A patient with an atretic cervix, dysplastic vagina, and a functional uterus.
  
  
  METHODS
  Creation of a neocervix by partial resection of the septum within a didelphic uterus and an uterovaginal fistula by the free microvascular transfer of a vermiform appendix and an 8-cm segment of ascending colon.
  
  
  METHODS
  Clinical follow-up examination to verify restoration of the outflow of menstrual blood and patency of the uterovaginal fistula.
  
  
  RESULTS
  The patient commenced menstrual bleeding 8 weeks postoperatively, after which she had regular menstrual cycles. The uterovaginal fistula was patent at the 3-year follow-up examination.
  
  
  CONCLUSIONS
  Free microvascular transfer of the appendix and ascending colon for creation of an uterovaginal fistula is an improved and superior technique for cervicovaginal reconstruction, with excellent long-term results.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
authors.forename: Chuan-Fei
authors.initials: CF
authors.lastname: Hou
authors.forename: Chin-Jung
authors.initials: CJ
authors.lastname: Wang
authors.forename: Chyi-Long
authors.initials: CL
authors.lastname: Lee
authors.forename: Hung-Chi
authors.initials: HC
authors.lastname: Chen
authors.forename: Yung-Kuei
authors.initials: YK
authors.lastname: Soong
mesh_terms: D000293:Adolescent; D000714:Anastomosis, Surgical; D001065:Appendix / Q000601:surgery*; D002584:Cervix Uteri / Q000002:abnormalities / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D044682:Colon, Ascending / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008598:Menstruation; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014621:Vagina / Q000002:abnormalities / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*