Applicability of Sigmoid Colon Graft for Vaginal Replacement (Colovaginoplasty) at Young Age

Abstract

Objective: - To evaluate the applicability, feasibility, complications, short and long term results of vaginoplasty by using sigmoid colon graft with stapler assistance for resuming colonic continuity in children with absent vagina. Patients and Methods: - Records of 15 patients 8 of them had Androgen Insensitivity Syndrome, 4 had congenital vaginal atresia, and 3 had Congenital Adrenal Hyperplasia, underwent sigmoid graft vaginal reconstruction with the aid of circular stapler during the period from 2005 to 2010 were reviewed retrospectively. Results: A neovagina was constructed in those patients who aged from 3 to 9 years (mean 4 years), where sigmoid colon was used in all patients. Hospital stay ranged from 5 to 12 days (mean 7), operative time ranged from 60 to 120 min (mean 75 min). All patients were followed up 6 monthly in the first year and then yearly, complications occurred in 4 patients: introital stenosis in 2, and another 2 cases had minor wound infection. The need for neovaginal dilation was indicated in 5 out of 15 patients. There was no complications related to bowel anastomosis, No mortality in this group and the cosmetic results were excellent in all cases. Conclusion: Sigmoid colovaginoplasty appears to be applicable for remedy of vaginal atresia at any age. It is associated with a less complication rate, the long term results is satisfactory and it seems a better technique, especially in girls who doesn’t expect sexual activity shortly after surgery.