Long-Term Outcomes of Vaginoplasty With Autologous Buccal Micromucosa

Li, Fengyong; Xu, Yansheng; Zhou, Chunxia; Zhou, Yu; Li, Senkai; Lu, Qiang

doi:10.1097/aog.0000000000000161

Cited by 32 publications

(16 citation statements)

References 16 publications

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“…Ostrzenski established a classification for a wide vagina from category A to D based on the presence/absence of columnar rugae and site-specific defects [6] ( Table 3). Vaginoplasty is mostly performed for patients with congenital vaginal deformities, women with a dysfunctional vagina, women with disorders of sex development, male-to-female transgender women in the medical literature [7][8][9][10][11][12][13], peritoneal vaginoplasty, intestinal vaginoplasty, and vaginoplasty with autologous buccal micromucosa [14][15][16][17][18][19]. In our case series, we include patients without any noticeable congenital deformity who seek improved sexual function and they do not require such an invasive surgical treatment for the correction of their vagina.…”

Section: Discussionmentioning

confidence: 99%

Vaginal Rejuvenation with Gore-Mycromesh

Park

Whang

2015

Aesth Plast Surg

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Recently, we introduced functional vaginal rejuvenation with elastic silicone threads. However, some patients with specific indications need other biocompatible materials for rejuvenation of the vagina. Gore-Mycromesh is one of the most commonly used materials in plastic and reconstructive surgical fields and it is composed of expanded poly-tetrafluroethylene. In this study, we introduced our clinical experience with static vaginal rejuvenation using Gore-Mycromesh to specifically assess the overall patient satisfaction (Female Sexual Function Index, FSFI). This study included 50 patients who underwent vaginal rejuvenation with a Gore-Mycromesh between 2010 and 2012. After marking two incisions at the inner side of the vaginal inlet and posterior wall, respectively, we performed submucosal dissection at the posterior vaginal wall and then grafted and secured a Gore-Mycromesh to the dissected area (muscle/fascia). Overall the FSFI improved as time progressed up to a year postoperatively. This is especially prominent in the FSFI satisfaction subscore. All but eight patients (42/50, 84 %) were "very satisfied (5)" or "satisfied (4)" with the outcomes after the vaginal rejuvenation. The overall complication rate was 8 %. Based on our clinical experience with the 50 cases, we think that vaginal rejuvenation with Gore-Mycromesh significantly improved postoperative outcomes, resulting in improved sexual function with a focus on improving the FSFI satisfaction subscore in mid-term follow-up. Elderly patients experience better outcomes using gore mycromesh rather than silicone thread because we can plicate the vaginal posterior wall with senile changes simultaneously using an open technique. However, further studies would be warranted for better positioning and adherence of grafted implants to surrounding tissue and for increasing the tightening effect of the implant and its sufficient longevity.

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Section: Discussionmentioning

confidence: 99%

Vaginal Rejuvenation with Gore-Mycromesh

Park

Whang

2015

Aesth Plast Surg

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“…Vaginal reconstruction for MRKH using autologous buccal mucosa has been described in both animal and human models (Table 1) [29-32, 34-35]. The use of fenestrated autologous buccal mucosa was described by Yesim Ozgenel et al [29] and Lin et al [30].…”

Section: Discussionmentioning

confidence: 99%

“…Complications reported included a urethral injury, oral contracture, and reoperation. The use of “micromucosa” was described by both Zhao et al [31] and Li et al [32] where buccal grafts were first minced into < 1-mm pieces either using a microskin machine or by hand to increase the expansion ratio and edges for growth. These pieces were spread onto gelatin sponges and placed into the neocavity (mucosa facing the cavity) followed by a stent placed to hold the grafted pieces in place.…”

Section: Discussionmentioning

confidence: 99%

“…Some promising results have been reported regarding the use of autologous buccal mucosa to form the neovagina since 2003 [29-32]. The advantages of using buccal tissue include secretory capacity, hairless texture, coloration similar to native vaginal tissue, distensibility, and inconspicuous scarring at the donor site [29].…”

Section: Introductionmentioning

confidence: 99%

“…Concerns have been raised that the size of the tissue obtained from the buccal region may be small relative to the surface area of the neovaginal cavity. Techniques described include mincing the buccal mucosa tissue obtained and applying it directly to the dissected neovagina space [31,32] and use of the whole fenestrated buccal graft [29,30,33,34]. Although many pediatric urologists are familiar with the technique of harvesting buccal mucosa [34], most gynecologists are not.…”

Section: Introductionmentioning

confidence: 99%

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Vaginoplasty with an Autologous Buccal Mucosa Fenestrated Graft in Two Patients with Vaginal Agenesis: A Multidisciplinary Approach and Literature Review

Chan

Levin

Ford

et al. 2017

Journal of Minimally Invasive Gynecology

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The objective of this case series is to describe the procedure and outcomes of a multidisciplinary approach to vaginoplasty using autologous buccal mucosa fenestrated grafts in two patients with vaginal agenesis. This procedure resulted in anatomic success with a functional neovagina with good vaginal length and caliber and satisfactory sexual function capacity and well healed buccal mucosa. There were no complications and patients were satisfied with surgical results. We conclude that the use of a single fenestrated graft of autologous buccal mucosa is a simple, effective procedure for the treatment of vaginal agenesis that results in an optimally functioning neovagina with respect to vaginal length, caliber, and sexual capacity.

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Neovaginal Construction with Pelvic Peritoneum: Reviewing an Old Approach for a New Application

et al. 2017

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Transgender reassignment surgeries have become a major topic of interest within the last decade. Although there are numerous surgical techniques for male-to-female reassignment, a physician must assess each patient's anatomy and past medical history to determine the most suitable technique. Additionally, patient preference is important. The neovaginal constructive technique most commonly used in male-to-female reassignment surgery is penile skin inversion, but various other techniques and tissues can also be used including pelvic peritoneum, buccal mucosa, and bowel. Surgical text descriptions were enhanced by creating new anatomical illustrations. Donor and recipient site anatomies, and the surgical technique leading to creation of the neovagina, are demonstrated in detail with relevant illustrations. A review of the literature concerning the anatomy, procedure development, and outcomes is presented. The pelvic peritoneum was originally used in neovaginal construction for females with vaginal agenesis as a result of MRKH syndrome. The use of this technique to create a neovagina in male-to-female transgender reassignment surgery has become appealing owing to the relative ease of the procedure, low complication rates, and overall high patient satisfaction. This technique offers a potential new choice for transgender male-to-female neovaginal construction, but further studies are needed to confirm its successful use in transgender surgery. Clin. Anat. 31:175-180, 2018. © 2017 Wiley Periodicals, Inc.

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Long-Term Outcomes of Vaginoplasty With Autologous Buccal Micromucosa

Abstract: III.

Cited by 32 publications

References 16 publications

Vaginal Rejuvenation with Gore-Mycromesh

Vaginal Rejuvenation with Gore-Mycromesh

Vaginoplasty with an Autologous Buccal Mucosa Fenestrated Graft in Two Patients with Vaginal Agenesis: A Multidisciplinary Approach and Literature Review

Neovaginal Construction with Pelvic Peritoneum: Reviewing an Old Approach for a New Application

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