Vaginal reconstruction using no grafts with evidence of squamous epithelialization in neovaginal vault: A simple approach

Aim: To present a simple approach for vaginal reconstruction, without lining of the neovagina by means of any grafts. Methods: This was an observational prospective cohort study. Twenty-five patients with a known diagnosis of vaginal agenesis were enrolled in this study between 2003 and 2009. All patients underwent vaginoplasty in which the McIndoe procedure was used with no grafts. Then we assessed vaginal depth, quality of life, sexual function, self-image and surgical complications with an interview, examination and by filling in the standard questionnaires in regards to the outcome of the surgery. Moreover, punch biopsy was taken from the neovagina at 3–12 months after surgery and the histology of samples was evaluated to determine squamous epithelialization of the neovagina. Results: Most of the patients in our study were satisfied with the outcome of surgery due to few complications. Moreover, punch biopsy after vaginal reconstruction determined complete epithelialization of the neovagina in six out of seven patients. Conclusions: The procedure described here offers patients a near-normal vagina with a simple, less invasive, low-cost procedure that provides squamous epithelialization of the neovaginal vault.