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Objective: To review the literature and report the incidence of vaginal stenosis (VS) after vaginoplasty and compare the incidence rates by surgical technique and follow-up duration., Methods: We performed a systematic literature review according to PRISMA guidelines. Original research on primary vaginoplasty was included. Exclusion criteria included non-English studies, mixed cohorts without subgroup analysis, revision vaginoplasty, and papers without stenosis rates. The search was ran in Pubmed, Embase, Scopus, and Cochrane on September 9, 2022. Stenosis rates were compared with descriptive statistics using SPSS., Results: Fifty-nine studies with a cumulative 7338 subjects were included. The overall incidence of VS was 5.83% (range 0%-34.2%). Combining VS with introital stenosis (IS) and contracture results in a cumulative incidence of 9.68%. The rate of VS in the penile inversion vaginoplasty subgroup (PIV) was 5.70%, compared to 0.20% in primary intestinal vaginoplasty. The rate of IS in the PIV group was 3.13% and 4.7% in the intestinal vaginoplasty subgroup., Conclusion: The overall rate of VS was 5.83%, which is lower than previously documented. This may be related to the inclusion of more recent studies and analysis limited to primary vaginoplasty. The similar rate of IS in PIV and intestinal vaginoplasty subgroups may be secondary to multiple suture lines and the need for dilation through this anastomosis. Our research demonstrates a need for a standardized definition of VS., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: To summarize the published literature regarding pelvic organ prolapse, dehiscence or evisceration, vaginal fistula, and dyspareunia after radical cystectomy and to describe the management approaches used to treat these conditions., Methods: Ovid MEDLINE, Ovid EMBASE, and Web of Science were systematically searched from January 1, 2001 to January 25, 2021 using a combination of search terms for bladder cancer and radical cystectomy with terms for four categories of vaginal complications (prolapse, fistula, evisceration/dehiscence, and dyspareunia). A total of 229 publications were identified, the final review included 28 publications., Results: Neobladder vaginal fistula was evaluated in 17 publications, with an incidence rate of 3 - 6% at higher volume centers, often along the anterior vaginal wall at the location of the neobladder-urethral anastomosis. Sexual function was evaluated in 10 studies, 7 of which utilized validated instruments. Maintaining the anterior vaginal wall and the distal urethra appeared to be associated with improved sexual function. Pelvic organ prolapse was assessed in 5 studies, only 1 used a validated questionnaire and none included a validated objective measure of pelvic organ support., Conclusion: There is a need for more prospective studies, using standardized instruments and subjective outcome measures to better define the incidence of vaginal complications after radical cystectomy for bladder cancer, and to understand their impact on quality of life measures., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Ventriculoperitoneal shunting is the most common treatment for hydrocephalus (excessive cerebrospinal fluid accumulation in the brain), but has the potential for serious complications such as shunt migration. Potential migration sites include the lateral ventricle mediastinum, gastrointestinal tract, abdominal wall, bladder, vagina, and scrotum., Case: Here, we present a rare case of vaginal extrusion of a ventriculoperitoneal shunt., Summary and Conclusion: Neurosurgeons and gynecologists should be aware of the potential occurrence of this rare complication., (Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. All rights reserved.)

Background: In recurrent/unresponsive vaginal discharge a vaginal foreign body should be considered., Case: We present the case of a 13-year-old girl who suffered from a foul-smelling dark brownish and malodorous vaginal discharge since the age of 7 years. When the girl was 11 years old, a foreign body was discovered on ultrasound imaging; removal by colposcopy failed, because of the complete battery inclusion in the posterior vaginal wall. Two years later, at our institution, radiological images yielded the general position of the foreign body; colposcopy showed complete vaginal stenosis. Forced dilatation allowed surgical removal of the battery which was embedded in the vaginal fundal wall., Summary and Conclusion: Early removal of foreign objects prevents ulceration, necrosis, stenosis, perforations, and late serious sequelae such as pelvic inflammation and infertility., (Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)

Background: Absence of the lower vagina occurs from abnormal development of the sinovaginal bulbs and vaginal plate., Case: We present a case of an adolescent girl, with a history of VACTERL and VATER status post flap vaginoplasty at 8 m of age and correction of vaginal-urethral fistula, with primary amenorrhea and cyclic pelvic pain. MRI showed a right hematocolpos. On exam the obstructed vagina was deviated to the right. Given prior urologic and rectal surgery, and laterality of unicornuate system, intra-operative ultrasonography (US) was performed. A needle was used to enter the inferior aspect of the obstructed vagina. A pull-through vaginoplasty was performed., Summary and Conclusion: Vaginal pull-through is the standard treatment for lower vaginal agenesis. In a unicornuate system, the use of intra-operative US is helpful to determine the appropriate angle of dissection., (Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)

Background: Vaginal bleeding is a rare occurrence in infancy and childhood. It is usually due to trauma, child abuse, foreign bodies, and rarely, a friable botryoid tumor., Case Summary: We discuss a case of a vaginal müllerian duct papilloma in a 2 year old infant that presented with vaginal bleeding., Discussion: To our knowledge, this is the second case reported in the literature of a vaginal müllerian duct papilloma presenting in a toddler. This rare type of tumor has an excellent prognosis when completely excised., Summary: A 2-year-old female that presented with bloody spotting in the diaper was found to have a vaginal.

Midurethral polypropylene slings are popular procedures for the treatment of stress urinary incontinence in women. Several commercially manufactured sling kits are available that use proprietary monofilament polypropylene mesh placed between the vaginal wall and midurethral segment. The BioArc sling system is a hybrid sling system that uses polypropylene mesh for fixation and autologous fascia for suburethral support. We report what we believe to be the first case of vaginal erosion after midurethral sling placement using this hybrid system.

Introduction: There are few published reports on the incidence and management of urethral and vaginal erosions following the use of polypropylene synthetic slings. Moreover, there is very little Australasian data on their use for management of female urinary incontinence or on their associated complications., Methods: A 1-page survey was mailed to the Australian and New Zealand members of the Urological Society of Australasia (N=326). The survey included questions on the use of polypropylene synthetic sling and the incidence and management of post-operative vaginal and urethral erosions and urinary retention., Results: 198 surveys were returned (response rate: 61%). Polypropylene synthetic sling procedure is practiced by 39% of the respondents with a total of 1459 cases (TVT: 993, SPARC: 466). The incidence of vaginal erosions, urethral erosions and urinary retention was 1.2%, 0.6% and 6.5%, respectively. Thirty five percent of vaginal erosions were asymptomatic and only identified on routine post-operative vaginal examination. One third of urethral erosions presented more than 1 year after surgery and 89% of these were symptomatic. Thirty four percent of patients with urinary retention required surgical intervention to correct the retention., Conclusions: The incidence of urethral and vaginal erosions following polypropylene synthetic sling procedures is lower than that with other synthetic slings. However, a high index of suspicion and long-term follow-up are required to identify and manage these complications of this relatively new procedure.

Study Objective: To document an unusual finding of a vaginal calculus in a patient with bladder exstrophy., Design: Case report., Setting: Tertiary Centre, Royal Children's Hospital, Melbourne, Australia., Participants: Fourteen year old female., Interventions: Cystotomy, introitoplasty., Main Outcome: Removal of vaginal calculus., Measures: None., Results: Documentation and removal of a vaginal calculus., Conclusions: Vaginal calculi should be included in the differential diagnosis of urolithiasis in patients with bladder exstrophy.

We present a unique case of obstructed vaginal duplication with ectopic ureteral drainage of an ectopic dysplastic kidney presenting as an antenatal diagnosis of a pelvic mass.

Stevens-Johnson syndrome is a rare, life-threatening condition characterized by epidermal necrosis and involvement of the mucosal surfaces. We report a case of Stevens-Johnson syndrome with vaginal involvement in an 11-yr-old girl who was treated conservatively in the acute stage of the disease. After recovery from the profound systemic upset, she underwent vaginoscopy, which demonstrated some adhesions, which were divided. We recommend that all patients with Stevens-Johnson syndrome with vaginal involvement undergo routine follow-up to evaluate possible adhesions.

Objectives: To evaluate the results and complications of a new transvaginal minimally invasive procedure for the treatment of stress urinary incontinence., Methods: Sixty-seven women aged 37 to 77 years underwent a pervaginal bone-anchoring synthetic sling procedure between April 1997 and February 1999. Sixty-three patients had a defect of the anatomic support, and 4 had iatrogenic intrinsic sphincteric deficiency (ISD). Patients were assessed at least 1 year postoperatively, underwent physical examination, and filled in the self-assessment questionnaire with the help of a nonpartisan health care provider. The questionnaire inquired about urine leakage, obstructive and irritative symptoms, quality of life, and satisfaction with the treatment received. The physician and questioner had no knowledge of each other., Results: Mean follow-up was 17 months. Perfect dryness was seen in 82% of patients with improvement in 9% and failure in 9%. Patients reporting a failed outcome were significantly older than those reporting improvement or cure (P = 0.01). All patients with ISD failed. Moderate obstructive symptom scores have been noticed in 31% of patients. Irritative voiding symptoms have been recorded in 22% of cured patients and 83% and 80% of improved and failed patients, respectively (P <0.001). Three percent of patients experienced pain during intercourse. Mild pelvic pain was found in 8% of patients. The only main complication of the operation was the vaginal erosion and sling removal in 16% of patients. Seventy-two percent of patients were completely satisfied with the treatment received., Conclusions: This procedure allows a high cure rate in patients with urinary incontinence due to a defect of anatomic support, and it is unsuitable when incontinence is due to ISD. The only main complication came from the use of the gelatin-coated Dacron sling that resulted in vaginal erosion, often necessitating the sling removal. The use of different synthetic or nonsynthetic materials may be advisable.

Purpose: The aim of this study was to report complications involving paraexstrophy skin flaps in the female bladder exstrophy closure., Materials and Methods: Bladder exstrophies in three female patients were initially closed using paraexstrophy skin flaps, with an osteotomy being performed in only 1 patient. A dehiscence occurred in all, and a reclosure was performed at a mean of 10 (range: 7-18) months after the initial closure., Results: Two patients underwent successful reclosure and are awaiting bladder neck reconstruction. The third patient, who had complete procidentia, had a bladder which failed to grow after successful reclosure and underwent augmentation cystoplasty., Conclusions: Closure of bladder exstrophy in female patients using paraexstrophy skin flaps can be associated with an increased complication rate and should be used judiciously in the exstrophy patient.

Vaginal evisceration is a rare complication of an enterocele. We report a patient who presented with spontaneous evisceration per vagina secondary to erosion through an attenuated vaginal wall. This resulted in a strangulated hernia requiring bowel resection and enterocele repair. This patient is discussed as are the risk factors and management options for patients with vaginal evisceration.

A prospective study to evaluate the role of vitamin C and cervico-vaginal infection in the premature rupture of amniotic membranes (PROM) was designed. The leukocyte vitamin C levels of 44 pregnant women that did not consume vitamin supplements was evaluated at weeks 20, 28 and 32 of pregnancy. On each evaluation the presence of cervico-vaginal infection was diagnosed and treated. The leukocyte vitamin C level throughout gestation showed a decrease towards week 28 and then it recovered at the end of pregnancy. Six of every ten women had normal flora in their vaginal secretion cultures. Eleven cases had PROM (0.24), no association was found between cervico-vaginal infection and PROM. The leukocyte vitamin C levels on week 20 of gestation showed an association with PROM. (chi 2 = 6.34, p < 0.05, odds ratio 6.75 [CI 1.26-26.03]).

A case report of vaginal calculus formation in a nine-year-old girl with myelodysplasia is presented. Etiologic factors in the formation of such calculi include fistulous communication between the vagina and the bladder, neuropathic urethrovesical dysfunction, anatomic conditions causing vaginal outlet obstruction, and/or vaginal pooling of urine and urease-producing bacterial infection. A correct preoperative diagnosis can be made by using oblique x-ray films and cystoscopy. Surgical treatment is simple and successful.

A rare case of vaginal stone in a male pseudohermaphrodite who had undergone plastic surgery for external genitalia 16 years ago is presented. It is recommended to remove the entire wall of vagina musculina at the time of plastic repair for hypospadias in a male pseudohermaphrodite.