title: Tunneled modified lotus petal flap for surgical reconstruction of severe introital stenosis after radical vulvectomy.
abstract: BACKGROUND
  We presented the anatomical, functional and aesthetic results achieved with lotus petal flap in case of introital stenosis as a results of inadequate primary plastic reconstruction. We discussed the potential advantages of lotus petal flap compared to others vulvar reconstructive techniques.
  
  
  METHODS
  We report a case of a 44-years old woman presenting a severe introital stenosis following radical surgery for vulvar cancer. She could not have a normal sexual activity life because the narrow scarred introitus resulting after primary closure of a large vulvar defect. The patient comes to our attention after three years from primary surgery. Once the scar was removed we performed a vulvoperineal reconstruction with bilateral tunneled lotus petal flaps.
  
  
  CONCLUSIONS
  Lotus petal flap is a safe, easy and quick technique, has a good functional and cosmetic results in this young woman, and represents an optimal alternative solution for plastic reconstruction in case of severe introital stenosis after primary closure of large vulvoperineal defect.
  
  
  CONCLUSIONS
  Tunneled lotus petal flaps represents a feasible, attractive and versatile surgical reconstructive technique that can be easily performed after surgical treatment of vulvoperineal neoplasms.
authors.affiliation: Department of Obstetrics and Gynecology, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Buda
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Confalonieri
authors.forename: Luca Carlo Vittorio
authors.initials: LC
authors.lastname: Rovati
authors.forename: Mauro
authors.initials: M
authors.lastname: Signorelli
authors.forename: Massimo
authors.initials: M
authors.lastname: Del Bene