High Posttraumatic Vaginal Stricture Combined With Urethrovaginal Fistula and Urethral Stricture in Girls: Reconstruction Using a Posterior Sagittal Pararectal Approach

Nikolayev, V. V.; Bizhanova, D.A.

doi:10.1016/s0022-5347(01)62293-6

Cited by 6 publications

(2 citation statements)

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“…Previous vaginal mobilization does not preclude a reattempt at vaginal mobilization. The posterior sagittal approach has been useful in the difficult setting of vaginal reconstruction after trauma [10], and for treating patients with cloaca who have developed complications from their original surgery, e.g. persistent or acquired urogenital sinus or vaginal atresia, with good results [11].…”

Section: Discussionmentioning

confidence: 99%

A posterior sagittal approach for revision vaginoplasty

Taghizadeh¹,

Wilcox²

2005

BJU International

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OBJECTIVETo review our experience with revision vaginoplasty without using bowel, by the posterior sagittal approach. PATIENTS AND METHODSThe notes of eight patients (median age 12.3 years, range 9.0-15.6) were retrospectively reviewed; all had had revision vaginoplasty using a posterior sagittal approach. Their original diagnosis was cloacal anomaly in three, urogenital sinus in two, cloacal exstrophy in two, and congenital adrenal hyperplasia in one patient. RESULTSIndications for re-operation included: haematocolpos in four patients, absent vaginal opening in two, hydrocolpos in one, and vesico-vaginal fistula in one. The vagina was reconstructed by total urogenital mobilization in seven patients and in one by anastomosing anterior and posterior aspects of a duplicated vagina. The vagina was mobilized by up to 6 cm in this manner. Bowel was not required for any of the vaginoplasties. The median (range) inpatient stay was 6 (4-17) days after surgery and the median follow-up was 35.3 (4.5-50) months. One patient developed a vesico-vaginal fistula and vaginal stenosis, and had further surgery. Two patients required subsequent use of vaginal dilators. The remainder have had a satisfactory outcome. CONCLUSIONSFor revisional vaginal surgery the posterior approach provides excellent exposure, and can be useful in dealing with a variety of pathologies. Combined with total urogenital mobilization, vaginoplasty can be successful despite long common channels. However, there were still several complications.

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Section: Discussionmentioning

confidence: 99%

A posterior sagittal approach for revision vaginoplasty

Taghizadeh¹,

Wilcox²

2005

BJU International

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“…PMA has also been used with either lateral traction of the rectum or transanally (15) for the treatment in children with the following lesions: posttraumatic and postradiation fistulas (10,13), presacral masses (11,15), complications associated with surgery of Hirschsprungs disease (13), urogenital sinus (14), anterior sacral meningocele (16), high vaginal strictures (10), and Mullerian duct remnants (5,7,9). The same approach has been used for the excision of a presacral teratoma in an adult (1).…”

Section: Discussionmentioning

confidence: 99%