YEDİ OLGUDA NÖROVASKULER PUDENDAL UYLUK FLEBİ İLE VAJİNA REKONSTRÜKSİYONU

Yıl 2003, Cilt: 4 Sayı: 3, 9 - 12, 17.09.2003

Eray Copcu Yücel Öztan

Öz

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Anahtar Kelimeler

Vajen, rekonstrüksiyon, nörovaskuler, pudendal, flep

Vaginal Reconstruction with Neurovascular Pudendal Thigh Flap in Seven Cases

Öz

Background:Reconstruction of the vulva, vagina and perineum is still a challenge for the plastic andreconstructive surgeons, gynecologists, pediatric surgeons, urologists and general surgeons. The majorindications for the reconstruction of the vagina are vaginal agenesis and post-oncological surgery. Manytechniques have been described for the reconstruction of this anatomical region. The neurovascular pudendalthigh flap is one of these.Material and methods:In this report we presented the results of the neurovascular pudendal thigh flap in sevenfemale patients with primary amenorrhea secondary to congenital vaginal agenesis.Results:There were no early or late complications in our series. Only hair growth was observed in three patientsbut this caused no complaints. Satisfactory functional, sensory and cosmetical results were achieved in allpatients within the post-operative six months.Conclusions:We concluded that neurovascular pudendal thigh flap is one of the most ideal techniques inreconstruction of the vagina due to its relatively simple technique, acceptable scar formation in donor area, lack ofneed for a stent in post-operative period, durable and reliable characteristics of the flap and successful functionaland cosmetical results

Anahtar Kelimeler

Vagina, reconstruction, neurovascular, pudendal, flap

Kaynakça

• 1. Horton CE Jr., Horton CE. Vaginal reonstruction. In Ehrlich RM, Alter GJ (eds) Reconstructive and plastic surgery of the external genitalia, 1st ed. Philadelphia:W.B. Saunders, 1999: 233-235.
• 2. Ghirardini G, Segre A. Vaginal agenesis (mayer - rokitansky - kuster - hauser syndrome): recent etiopathogenetical and anatomical views. Clin Exp Obstet Gynecol 1982; 9:98-102.
• 3. Karim RB, Hage JJ, Dekker JJ, Schoot CM. Evolution of the methods of neovaginoplasty for vaginal aplasia. Eur J Obstet Gynecol Reprod Biol 1995; 58:19-27.
• 4. Gurlek A, Monstrey S Prof S. The versatility of the pudendal thigh fasciocutaneous flap used as an island flap. Plast Reconstr Surg 2002; 109:402-3.
• 5. Joseph VT. Pudendal-thigh flap vaginoplasty in the reconstruction of genital anomalies. J Pediatr Surg 1997; 32:62-5.
• 6. Oosterlinck W, Monstrey S. The pudendal thigh fasciocutaneous flap to cover deep perineal defects, combined with reconstruction of the posterior urethra. BJU Int 2002; 89:133-5.
• 7. Monstrey S, Blondeel P, Van Landuyt K, Verpaele A, Tonnard P, Matton G. The versatility of the pudendal thigh fasciocutaneous flap used as an island flap. Plast Reconstr Surg 2001; 107(3):719-25.
• 8. Buss JG, Lee RA. McIndoe procedure for vaginal agenesis: results and complications. Mayo Clin Proc 1989; 64:758-61.
• 9. Hagerty RC, Vaughn TR, Lutz MH. The perineal artery axial flap in reconstruction of the vagina. Plast Reconstr Surg 1988; 82:344-5.
• 10. Wee JT, Joseph VT. A new technique of vaginal reconstruction using neurovascular pudendal- thigh flaps: a preliminary report. Plast Reconstr Surg 1989; 83:701-9.
• 11. Ralston DR, Tunney P, Orton CI, Elstein M. The use of a tissue expander as a vaginal stent in vaginal reconstruction. Br J Obstet Gynaecol 1995; 102:62-3.
• 12. Tamaya T, Imai A. The use of peritoneum for vaginoplasty in 24 patients with congenital absence of the vagina.Arch Gynecol Obstet 1991; 249:15-7.
• 13. Ashworth MF, Morton KE, Dewhurst J, Lilford RJ, Bates RG. Vaginoplasty using amnion. Obstet Gynecol 1986; 67:443-6.
• 14. Copeland LJ, Hancock KC, Gershenson DM, Stringer CA, Atkinson EN, Edwards CL. Gracilis myocutaneous vaginal reconstruction concurrent with total pelvic exenteration. Am J Obstet Gynecol 1989; 160:1095-101.
• 15. Sadove RC, Horton CE. Utilizing full-thickness skin grafts for vaginal reconstruction. Clin Plast Surg 1988; 15:443-8.
• 16. Velidedeoðlu H, Karacaoðlan N, Bozdoðan N, Þahin Ü, Aksoylar A, Kurtay A, Türkgüven Y. 41 Vajinal Agenezis Olgusunun Nörovaskü ler Pudental Thigh Flep ile Rekonstrüksiyonundan Alýnan Sonuçlar.Yeni Týp Dergisi 1995; 12: 35-38
• 17. McCraw JB, Massey FM, Shanklin KD, Horton CE. Vaginal reconstruction with gracilis myocutaneous flaps. Plast Reconstr Surg 1976;58: 176-78 Ê
• 18. Lilford RJ, Johnson N, Batchelor A. A new operation for vaginal agenesis: Construction of a neo-vagina from a rectus abdominis musculocutaneous flap. Br. J Obstet Gynaecol 1989; 96: 1089-90
• 19. Levy JB, Darson MF, Bite U, Kramer SA. Modified pudendal-thigh flap for correction of penoscrotal transposition. Urology 1997; 50:597-600.
• 20. Monstrey S, Blondeel P, Van Landuyt K, Verpaele A, Tonnard P, Matton G. The versatility of the pudendal thigh fasciocutaneous flap used as an island flap. Plast Reconstr Surg 2001; 107:719-25.
• 21. Kelemen Z, Lehoczky G. Closure of severe vesicovagino-rectal fistulas using Lehoczky´s island flap. Br J Urol 1987; 59: 153
• 22. Gürlek A, Gherardini G, Görgü M, Erdogan B, Coban YK, Evans GRD. The repair of multiple recto-vaginal fistulas with the neurovascular flap (Singapore flap): A case report. Plast Reconstr Surg 1997; 99: 2071