Long-term outcomes of vaginoplasty with autologous buccal micromucosa.
OBJECTIVE
To evaluate the technical feasibility and anatomical and functional outcomes of one-stage vaginoplasty with autologous buccal micromucosa.


METHODS
We retrospectively reviewed our experiences with 38 patients with vaginal agenesis treated with primary surgery from June 2006 to April 2012. All patients underwent transvestibular vaginoplasty with autologous buccal micromucosa. We describe the details of this technique and evaluate the long-term anatomical, functional, and sexual outcomes.


RESULTS
A total of 38 patients (33 with Mayer-Rokitansky-Kuster-Hauser syndrome and five with complete androgen insensitivity syndrome) were included in the present study. The mean operative time was 86.4 minutes (range 75-120 minutes). The mean blood loss was 68.5 mL (range 40-80 mL). At a mean follow-up of 33.5 months (range 15-76 months), the mean depth of the neovagina was 8.5±0.66 cm (range 7-10 cm), the mean circumference was 12.3±1.24 cm (range 10-15 cm), and the mean volume was 100±8 mL (range 85-120 mL). By histologic examination, we found the neovaginal mucosa was stratified nonkeratinized squamous mucosa and had secretory function. The mean female sexual function index score of the 32 sexually active patients was 28.8±2.1. No spouse reported discomfort during intercourse. The mean postoperative dependence on the vaginal stent was 15±2.1 months (range 9-20 months).


CONCLUSIONS
Transvestibular vaginoplasty with autologous buccal micromucosa is an effective and feasible approach for patients with Mayer-Rokitansky-Kuster-Hauser syndrome and complete androgen insensitivity syndrome. The procedure has satisfactory long-term anatomical and functional results.


METHODS
III.
10th Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical School, and the Department of Urology, Navy General Hospital of The People's Liberation Army, Beijing, China.
Feng-Yong
FY
Li
Yan-Sheng
YS
Xu
Chuan-de
CD
Zhou
Yu
Y
Zhou
Sen-Kai
SK
Li
Qiang
Q
Li
D058489:46, XX Disorders of Sex Development / Q000601:surgery; D000293:Adolescent; D000328:Adult; D013734:Androgen-Insensitivity Syndrome / Q000601:surgery; D016063:Blood Loss, Surgical; D003075:Coitus; D000013:Congenital Abnormalities / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008297:Male; D009061:Mouth Mucosa / Q000637:transplantation*; D009095:Mullerian Ducts / Q000002:abnormalities / Q000601:surgery; D061646:Operative Time; D012189:Retrospective Studies; D019529:Sexuality; D015607:Stents; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery*; D055815:Young Adult