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The Use of Autologous Buccal Mucosa Grafts for Vaginoplasty
Laura Horodyski, Janie Benoit MD, Ann Schwentker MD, Lesley Breech MD, Belinda Hsi Dickie MD PhD
University of Cincinnati College of Medicine
2016-02-01
Presenter: Laura Horodyski
Affidavit:
Ann R. Schwentker
Director Name: Ann R. Schwentker
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background:
Varying techniques are described for repair of congenital or acquired vaginal stenosis or agenesis, but there is no consensus on the optimal approach. Autologous buccal mucosa has been recently described, and has potential for superior functional outcomes. The grafted tissue has good elasticity, readily undergoes neovascularization, and is nearly identical histologically to vaginal mucosa, and this technique avoids many complications of the traditional approaches, such as malodorous discharge, intravaginal hair growth, and inadequate vaginal lubrication. We present a multidisciplinary approach to vaginal reconstruction using buccal mucosa.
Methods:
A retrospective review was conducted for 10 patients who have undergone vaginoplasty with autologous buccal mucosa grafts from 2011-2016. Grafts were harvested by the plastic surgery team and inset into defects by the gynecology and colorectal team, using inflatable vaginal stents for internal grafts and tie-over bolsters for introitoplasty.
Results:
No patients had additional vaginal reconstructive surgery during followup (1-60 months), although two did have graft stenosis and one of these required dilation under anesthesia. All patients performed daily dilation after the vaginoplasty. Five of seven patients in stable relationships were later sexually active, four without dyspareunia. Two patients had short-term oral numbness after the procedure, and one had decreased oral opening.
Conclusion:
Vaginoplasty with autologous buccal mucosa grafts is a promising new technique that avoids some of the serious drawbacks of traditional approaches. This method results in minimal long-term complications and provides new vaginal tissue that is nearly identical to native mucosa, potentially allowing for future sexual intercourse without dyspareunia.
