title: [Comparative study on laparoscopic vaginoplasty using pedicled ileal and sigmoid colon segment transfer].
abstract: OBJECTIVE
  To study the clinical effect of laparoscopic vaginoplasty using pedicled ileal and sigmoid colon segment.
  
  
  METHODS
  From January 2004 to December 2009, 105 cases undergoing laparoscope-assisted vaginoplasty using a vascularized pedicled intestinal flap were studied retrospectively. Operation time, blood loss in operating, bowel movement after operation, postoperation hospital duration, side effect, and artificial vagina were compared between two surgical management.
  
  
  RESULTS
  The vaginoplasty were preformed successfully in all 105 cases. There were 48 patients treated by aparoscope-assisted ileal vaginoplasty and 57 patients treated by laparoscope-assisted sigmoid colon vaginoplasty. The values of the operation time [(141 ± 22) minutes versus (159 ± 18) minutes, P = 0.000], blood loss in operating [(42 ± 6) ml versus (83 ± 14) ml, P = 0.000], bowel movement after operation (36 ± 9) hours versus (68 ± 8) hours(P = 0.000), and postoperation hospital duration [(9.8 ± 2.0) days versus (11.1 ± 1.3) days, P = 0.004] in the sigmoid colon vaginoplasty group were longer or higher than those in ileal vaginoplasty group (P < 0.05).No intraoprative complication occurred. There were four postoperative complications: 2 cases with intestinal obstruction in sigmoid colon vaginoplasty group, 1 case with urethral orifice stenosis and 1 case with vaginal-rectal fistula in ileal vaginoplasty group. At follow-up of 6-62 months, all artificial vaginas had a capacity of over two fingers in wideness and 12-15 cm in length. Vaginal discharges resembled a milky white water or mucus without odour. Fifty-five patients with sexual intercourse reported satisfactory results.Six patients complained vaginal stenosis:5 patients in ileal vaginoplasty group and 1 patient in sigmoid colon vaginoplasty group.
  
  
  CONCLUSIONS
  Laparoscope-assisted vaginoplasty using pedicled ileum or sigmoid colon segment are both the effective ways in forming vagina. The latter management takes more time and blood loss while operating, yet the incidence of vaginal opening contracture appeared to be decreasing trend.
authors.affiliation: Department of Obstetrics and Gynecology,Beijing Anzhen Hospital, Capital Medical University,Beijing 100029, China.
authors.forename: Dawei
authors.initials: D
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.forename: Huanying
authors.initials: H
authors.lastname: Wang
authors.affiliation: Email: anzhenlibin@126.com.
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.forename: Xiaoxing
authors.initials: X
authors.lastname: Zhu
authors.forename: Liying
authors.initials: L
authors.lastname: Wang
authors.forename: Jixiang
authors.initials: J
authors.lastname: Wu
mesh_terms: D000328:Adult; D012809:Colon, Sigmoid / Q000637:transplantation*; D000013:Congenital Abnormalities / Q000601:surgery; D005260:Female; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014621:Vagina / Q000002:abnormalities / Q000601:surgery*; D055815:Young Adult