title: Surgical and functional outcomes of sigmoid vaginoplasty among patients with variants of disorders of sex development.
abstract: OBJECTIVE
  To assess the use of sigmoid colon in vaginal reconstruction of some patients with disorders of sex development.
  
  
  METHODS
  The study included 31 patients with disorders of sex development of various causes. All were reared as females. Female gender was decided for all cases after complete medical assessment. All patients underwent sigmoid vaginoplasty. Assessment of surgical and functional outcomes was carried out in a follow-up period of up to 6 years.
  
  
  RESULTS
  The preoperative diagnoses included mullerian aplasia (16 cases), androgen insensitivity syndrome (12 cases) and previous failed vaginoplasty (3 cases). Associated surgical procedures were gonadectomy in 5 cases and gonadectomy combined with clitoroplasty and vulvoplasty in 7 cases. No intra-operative or early postoperative complications occurred. A cosmetic neovagina with adequate size was achieved in all cases. Long term follow-up showed introital stenosis in 4 cases (12.9 %). Two of them responded to vaginal dilatation. The third one needed y-v plasty while the fourth one presented by acute abdomen secondary to ruptured vagina and was submitted to urgent laparotomy. Mucosal prolapse occurred in 1 case (3.2 %). Reoperation rate was 9.6 %. Sexual satisfaction was achieved among 9 sexually active cases. The subjective satisfaction score of the surgical outcome was 8.03.
  
  
  CONCLUSIONS
  For patients with disorders of sex development of various etiologies, sigmoid vaginoplasty is the preferred technique for vaginal replacement. It is a safe technique that provides the patient with a cosmetic neovagina of adequate caliber and a satisfactory functional outcome.
authors: Departments of Urology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors: A
authors: A
authors: Nowier
authors: M
authors: M
authors: Esmat
authors: R T
authors: RT
authors: Hamza
mesh_terms: D058489:46, XX Disorders of Sex Development / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D013734:Androgen-Insensitivity Syndrome / Q000601:surgery*; D012809:Colon, Sigmoid / Q000637:transplantation*; D000013:Congenital Abnormalities / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D008297:Male; D009095:Mullerian Ducts / Q000002:abnormalities / Q000601:surgery; D061646:Operative Time; D017060:Patient Satisfaction; D011184:Postoperative Period; D015203:Reproducibility of Results; D013997:Time Factors; D016896:Treatment Outcome; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery*; D055815:Young Adult