Reconstrução vaginal pelo retalho neurovascular pudendo crural na síndrome de Rokitansky

Abstract

BACKGROUND: Congenital vaginal agenesis, with a prevalence of 1 in 4000 or 5000 females, occurs mainly as a feature of the Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. The management of this patient includes psychological support and the creation of a neovagina. OBJECTIVE: To present and evaluate the pudendal thigh flap for the creation of a neovagina in eight young women with MRKH syndrome. METHODS: Eight young women with MRKH syndrome had a neovagina created by using the bilateral pudendal thigh fasciocutaneous flap procedure, Singapore flap. The patients' follow-up ranged between 6 months and 3 years. RESULTS: A functional vagina of at least 10cm in depth and 5cm in width was created in al cases. Although the patients reported moderated local pain after the procedure, they were satisfied with the results. In addition, normal sexual life was possible after 40 days and none of them reported bleeding or pain during sexual relation. Three patients presented hair in the vaginal lining. CONCLUSION: Bilateral fasciocutaneous pudendal thigh flap permits vaginal reconstruction with some advantages such as postoperative dilatation is not necessary, sensation is maintained and the resulting scars are inconspicuous.