Pudendal thigh flap in the treatment of acquired gynatresia from caustic pessaries.

Abstract

OBJECTIVES:

To evaluate the use of vaginoplasty with the pudendal thigh flap in patients with gynatresia caused by herbal pessaries in a multidisciplinary context.

METHODS:

The study included patients with herbal-pessary-induced vaginitis and gynatresia. Surgical treatment consisted of vaginoplasty with the pudendal thigh flap; patients with associated fibroids had a myomectomy during the same setting. The severity of the stenosis and the outcome after surgery were assessed with rating scales devised for the present study.

RESULTS:

The study included 21 patients (mean age 36.05 ± 1.69 years, range 18-50 years). The most common reason for herbal pessary use was fibroids with infertility. Prior to presentation, most patients had already undergone a median of 2 procedures involving vaginal adhesiolysis and dilatations without improvement. In total, 17 (80.9%) patients underwent surgery. Of these, 6 (35.3%) presented with both fibroids and gynatresia. Before surgery, all patients had poor sexual function with apareunia. Postoperatively, 11 (64.7%) patients reported painless sexual intercourse.

CONCLUSION:

Joint management by plastic surgeons and gynecologists using the pudendal thigh flap for vaginoplasty in caustic gynatresia resulted in a functional vagina. Simultaneous myomectomy and vaginoplasty in patients with fibroids and gynatresia was safe.

• Authors: Andrew O Ugburo, Bolaji O Mofikoya, Ayodeji A Oluwole, Idowu O Fadeyibi, Gbadegesin Abidoye
• Journal: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (Int J Gynaecol Obstet) Vol. 115 Issue 1 Pg. 44-8 (Oct 2011) ISSN: 1879-3479 [Electronic] United States
• PMID: 21767838 (Publication Type: Journal Article)
• Copyright: Copyright © 2011. Published by Elsevier Ireland Ltd.

Topics

• Adolescent
• Adult
• Burns, Chemical (pathology, surgery)
• Female
• Gynatresia (chemically induced, surgery)
• Humans
• Leiomyoma (surgery)
• Medicine, African Traditional (adverse effects, methods)
• Middle Aged
• Nigeria
• Pessaries (adverse effects)
• Plastic Surgery Procedures (methods)
• Severity of Illness Index
• Surgical Flaps
• Treatment Outcome
• Vaginitis (chemically induced, surgery)
• Young Adult