Vaginal reconstruction has been performed for more than a century. Main complications
are vaginal stenosis requiring dilatation, dyspareunia, excessive mucus secretion,
and poor aesthetic and functional outcome. Here we report a new operation method modified
after Baldwin for intestinal vaginoplasty in a patient with pelvic exenteration after
spinal cell carcinoma of the vagina. Because of balanced liquid resorption and mucus
secretion with sufficient vessel length in the terminal ileum, this intestinal segment
was chosen. A J-pouch of distal ileum was constructed pedicled on the ileocolic artery
and accompanying nervous plexus, transferred into the lower pelvis and sutured to
the vaginal stump. One year follow-up showed a highly satisfied, sexually active patient,
with adequate vaginal size, optimal lubrication and no molesting fecal odor. Terminal
ileum J-pouch vaginoplasty is an optimal method for vaginal reconstruction providing
a sufficient vaginal lumen and lubrication and thereby restoring patients' sexual
life and increasing life quality.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Obstetrics & GynecologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Vaginal reconstruction in gynecological oncology: a review of techniques.Obstet Gynecol Surv. 1981; 36: 1-10
- Ein neues verfahren der künstlichen scheidenbildung.Zentralbl Gynakol. 1930; 54: 2690
- An operation for the cure of congenital absence of the vagina.J Obstet Gynaecol Br Commonw. 1938; 45: 490-494
- Congenital absence of the vagina: long-term results of vaginal reconstruction 175 cases.Am J Obstet Gynecol. 1968; 100: 752-763
- Complications and sexual function after vaginectomy for anorectal tumors.Dis Colon Rectum. 2007; 50: 810-816
- Rectus abdominis myocutaneous flaps for neovaginal reconstruction after radical pelvic surgery.Int J Gynecol Cancer. 2005; 15: 542-548
- A new technique of vaginal reconstruction with the deep inferior epigastric perforator flap: a preliminary report.Plast Reconstr Surg. 2007; 119: 1785-1790
- Gluteal fold V-Y advancement flap for vulvar and vaginal reconstruction: a new flap.Plast Reconstr Surg. 2006; 118: 401-406
- Total pelvic exenteration: the Albert Einstein College of Medicine/Montefiore Medical Center experience (1987 to 2003).Gynecol Oncol. 2006; 101: 261-268
- Un cas d'établissement d'un vagin artificiel au moyen d'une nouvelle méthod opératoire.Arch de Tocnologie et de Gynaecologie. 1892; 19: 568-577
- The formation of an artificial vagina by intestinal transplantation.Ann Surg. 1904; 40: 398-403
- Vaginal reconstruction using the ileocecal segment after resection of pelvic malignancy.J Egypt Natl Cancer Inst. 2006; 18: 1-7
- Ileocecal vaginal construction.Am J Obstet Gynecol. 1989; 161: 162-167
- Anterior pelvic reconstruction with ileum after cancer treatment.J R Soc Med. 1991; 84: 709-713
- Laparoscopic mobilization of neovagina to assist secondary ileal vaginoplasty in male-to-female transsexuals.Urology. 2005; 66: 293-298
- Vaginal replacement in children and young adults.J Urol. 1998; 159: 1035-1038
- Intestinal vaginoplasty: is it optimal treatment of vaginal agenesis?.Int Urogynecol J Pelvic Floor Dysfunct. 2006; 17: 40-45
- Sexual function following bowel vaginoplasty.J Urol. 2006; 175: 2283-2286
- Mucinous adenocarcinoma arising in a neovagina using the sigmoid colon thirty years after operation: a case report.J Surg Oncol. 2001; 77: 61-64
- Adenocarcinoma in a sigmoid neovagina 22 years after Wertheim-Meigs operation: case report.Eur J Gynaecol Oncol. 1994; 15: 24-28
- Total colectomy, mucosal proctectomy, and ileoanal anastomosis.Dis Colon Rectum. 1980; 23: 459-466
- Ileal pouch-anal anastomosis.Br J Surg. 2007; 94: 812-823
- Pouch reconstruction in the pelvis.Langenbecks Arch Surg. 2003; 388: 60-75
- Formation of an artificial vagina by a new plastic technique.Am J Obstet Gynecol. 1927; 14: 712-718
- The treatment of congenital absence and obliterative conditions of the vagina.Br J Plast Surg. 1950; 2: 254-267
- Vaginal atresia corrected by use of small and large bowel.Clin Obstet Gynecol. 1972; 15: 639-649
- Vaginal construction.Urology. 1987; 29: 272-275
- Transverse retubularized ileal vaginoplasty: a new application of the Monti principle—preliminary report.Eur Urol. 2005; 48: 1018-1023
- Surgical management of cloacal malformations: a review of 339 patients.J Pediatr Surg. 2004; 39: 470-479
- The ileal neobladder: complications and functional results in 363 patients after 11 years of follow-up.J Urol. 1999; 161: 422-427
- Primary vaginal and pelvic floor reconstruction at the time of pelvic exenteration: a study of morbidity.Gynecol Oncol. 2000; 77: 293-297
- Complicated postirradiation vesicovaginal fistula in young women: keep off or try reconstruction?.Eur Urol. 2007; 51: 243-246
- Diversion colitis in sigmoid neovagina.Colorectal Dis. 2004; 6: 290-291
- The occurrence of diversion colitis in patients with a sigmoid neovagina.Hum Pathol. 1993; 24: 846-849
- Ulcerative colitis in a sigmoid neovagina.N Engl J Med. 2000; 343: 369
Article info
Publication history
Published online: April 20, 2009
Footnotes
Cite this article as: Schneider W, Nguyen-Thanh P, Dralle H, et al. Ileal J-pouch vaginoplasty. Am J Obstet Gynecol 2009;200:694.e1-694.e4.
Identification
Copyright
© 2009 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- CorrectionAmerican Journal of Obstetrics & GynecologyVol. 201Issue 2
