EFFECTIVENESS OF VAGINOPLASTY WITH ACELLULAR DERMAL MATRIX AND MIXED PARTICLES GRAFT_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHOUYu ,  LIQiang , LISenkai , ZHOUChuande , LIFengyong , CAOYujiao , ZHANGSiya , WEIShuyi , ZHAOYang

The 10 th Department of Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100144, P. R. China;

Corresponding author：

LIQiang, Email: drliqiang50@163.com

Keywords：

Vaginoplasty; Buccal micro mucosa; Acellular dermal matrix; Vaginal agenesis

DOI：

10.7507/1002-1892.20150163

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the effectiveness of acellular dermal matrix (ADM) with autologous buccal micro mucosa and micro skin graft in vaginoplasty. Methods A retrospective analysis was made on the clinical data of 67 patients with vaginal agenesis treated between July 2006 and June 2013. ADM and mixed particles were used in 20 cases (ADM group) and mixed particles graft in 47 cases (control group) in vaginoplasty. There was no significant difference in age between 2 groups (t=0.233, P=0.816). The depth, diameter, and volume of neovagina, epithelization time, stent needing time, and female sexual function index (FSFI) score were compared between 2 groups. Results There was no significant difference in operation time and amount of bleeding between 2 groups (t=-1.922, P=0.059; t=0.398, P=0.692). The patients were followed up 11-38 months (mean, 16.08 months). Fifteen cases in ADM group and 29 cases in control group had sexual life after operation. Bleeding after operation occurred in 6 cases (2 in ADM group and 4 in control group). No stenosis was observed. Difference in epithelization time was not statistically significant (t=-1.938, P=0.057). However, the stent needing time of ADM group was significantly shorter than that of control group (t=7.020, P=0.000). The neovagina was ideal in wetness degree, smoothness, flexibility, and hairlessness during follow-up. The depth, diameter, and volume of vagina had no significant difference between 2 groups (P>0.05) at last follow-up, which were close to normal vagina. The other patients had normal sexual function except 1 patient whose FSFI score was less than 23; no statistically significant difference was found in FSFI score between 2 groups (P>0.05). Conclusion On the basis of mixed particles grafting, the ADM could improve trestle structure for resisting contracture. The effectiveness is better than merely mixed particles graft. The procedure has satisfactory anatomical and functional results.

Citation： ZHOUYu, LIQiang, LISenkai, ZHOUChuande, LIFengyong, CAOYujiao, ZHANGSiya, WEIShuyi, ZHAOYang. EFFECTIVENESS OF VAGINOPLASTY WITH ACELLULAR DERMAL MATRIX AND MIXED PARTICLES GRAFT. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(6): 761-765. doi: 10.7507/1002-1892.20150163 Copy

1.	Nakhal RS, Creighton SM. Management of vaginal agenesis. J Pediatr Adolesc Gynecol, 2012, 25(6):352-357.
2.	Allen LM, Lucco KL, Brown CM, et al. Psychosexual and functional outcomes after creation of a neovagina with laparoscopic Davydov in patients with vaginal agenesis. Fertil Steril, 2010, 94(6):2272-2276.
3.	Bouman MB, van Zeijl MC, Buncamper ME, et al. Intestinal vaginoplasty revisited:a review of surgical techniques, complications, and sexual function. J Sex Med, 2014, 11(7):1835-1847.
4.	Lanza H, Balestrelli J, Pastoni D, et al. Vaginoplasty technique using vulvoperineal flaps. Aesthetic Plast Surg, 2014, 38(1):164-168.
5.	Spyropoulou GA, Jeng SF, Demiri E, et al. Reconstruction of perineoscrotal and vaginal defects with pedicled anterolateral thigh flap. Urology, 2013, 82(2):461-465.
6.	Kim SW, Lee WM, Kim JT, et al. Vulvar and vaginal reconstruction using the "angel wing" perforator-based island flap. Gynecol Oncol, 2015.[Epub ahead of print].
7.	Erman Akar M, Özkan Ö, Colak T, et al. Sexual function and long-term results following vaginal reconstruction with free vascular jejunal flap. J Sex Med, 2013, 10 (11):2849-2854.
8.	Willemsen WN, Kluivers KB. Long-term results of vaginal construction with the use of Frank dilation and a peritoneal graft (Davydov procedure) in patients with Mayer-Rokitansky-Küster syndrome. Fertil Steril, 2015, 103(1):220-227.e1.
9.	Sun X, Li C, Jin L, et al. Development and validation of Chinese version of female sexual function index in a Chinese population-a pilot study. J Sex Med, 2011, 8(4):1101-1111.
10.	Yeşim Ozgenel G, Ozcan M. Neovaginal construction with buccal mucosal grafts. Plast Reconstr Surg, 2003, 111(7):2250-2254.
11.	Lin WC, Chang CY, Shen YY, et al. Use of autologous buccal mucosa for vaginoplasty:a study of eight cases. Hum Reprod, 2003, 18(3):604-607.
12.	赵穆欣. 自体口腔黏膜微粒移植修复创面的实验研究及在阴道再造术中的临床应用. 北京:中国协和医科大学, 2009.
13.	Zhao M, Li P, Li S, et al. Use of autologous micromucosa graft for vaginoplasty in vaginal agenesis. Ann Plast Surg, 2009, 63(6):645-649.
14.	Li FY, Xu YS, Zhou CD, et al. Long-term outcomes of vaginoplasty with autologous buccal micromucosa. Obstet Gynecol, 2014, 123(5):951-956.
15.	周宇, 李森恺, 周传德, 等. 自体微粒口腔黏膜游离移植阴道再造术在性发育疾病中的应用. 中华整形外科杂志, 2013, 29(6):457-459.
16.	Li X, Meng X, Wang X, et al. Human acellular dermal matrix allograft:A randomized, controlled human trial for the long-term evaluation of patients with extensive burns. Burns, 2015.[Epub ahead of print].
17.	Mendenhall SD, Anderson LA, Ying J, et al. The BREASTrial:stage I. Outcomes from the time of tissue expander and acellular dermal matrix placement to definitive reconstruction. Plast Reconstr Surg, 2015, 135(1):29e-42e.
18.	Gaynor BG, Benveniste RJ, Lieberman S, et al. Acellular dermal allograft for sellar repair after transsphenoidal approach to pituitary adenomas. J Neurol Surg B Skull Base, 2013, 74(3):155-159.

1. Nakhal RS, Creighton SM. Management of vaginal agenesis. J Pediatr Adolesc Gynecol, 2012, 25(6):352-357.
2. Allen LM, Lucco KL, Brown CM, et al. Psychosexual and functional outcomes after creation of a neovagina with laparoscopic Davydov in patients with vaginal agenesis. Fertil Steril, 2010, 94(6):2272-2276.
3. Bouman MB, van Zeijl MC, Buncamper ME, et al. Intestinal vaginoplasty revisited:a review of surgical techniques, complications, and sexual function. J Sex Med, 2014, 11(7):1835-1847.
4. Lanza H, Balestrelli J, Pastoni D, et al. Vaginoplasty technique using vulvoperineal flaps. Aesthetic Plast Surg, 2014, 38(1):164-168.
5. Spyropoulou GA, Jeng SF, Demiri E, et al. Reconstruction of perineoscrotal and vaginal defects with pedicled anterolateral thigh flap. Urology, 2013, 82(2):461-465.
6. Kim SW, Lee WM, Kim JT, et al. Vulvar and vaginal reconstruction using the "angel wing" perforator-based island flap. Gynecol Oncol, 2015.[Epub ahead of print].
7. Erman Akar M, Özkan Ö, Colak T, et al. Sexual function and long-term results following vaginal reconstruction with free vascular jejunal flap. J Sex Med, 2013, 10 (11):2849-2854.
8. Willemsen WN, Kluivers KB. Long-term results of vaginal construction with the use of Frank dilation and a peritoneal graft (Davydov procedure) in patients with Mayer-Rokitansky-Küster syndrome. Fertil Steril, 2015, 103(1):220-227.e1.
9. Sun X, Li C, Jin L, et al. Development and validation of Chinese version of female sexual function index in a Chinese population-a pilot study. J Sex Med, 2011, 8(4):1101-1111.
10. Yeşim Ozgenel G, Ozcan M. Neovaginal construction with buccal mucosal grafts. Plast Reconstr Surg, 2003, 111(7):2250-2254.
11. Lin WC, Chang CY, Shen YY, et al. Use of autologous buccal mucosa for vaginoplasty:a study of eight cases. Hum Reprod, 2003, 18(3):604-607.
12. 赵穆欣. 自体口腔黏膜微粒移植修复创面的实验研究及在阴道再造术中的临床应用. 北京:中国协和医科大学, 2009.
13. Zhao M, Li P, Li S, et al. Use of autologous micromucosa graft for vaginoplasty in vaginal agenesis. Ann Plast Surg, 2009, 63(6):645-649.
14. Li FY, Xu YS, Zhou CD, et al. Long-term outcomes of vaginoplasty with autologous buccal micromucosa. Obstet Gynecol, 2014, 123(5):951-956.
15. 周宇, 李森恺, 周传德, 等. 自体微粒口腔黏膜游离移植阴道再造术在性发育疾病中的应用. 中华整形外科杂志, 2013, 29(6):457-459.
16. Li X, Meng X, Wang X, et al. Human acellular dermal matrix allograft:A randomized, controlled human trial for the long-term evaluation of patients with extensive burns. Burns, 2015.[Epub ahead of print].
17. Mendenhall SD, Anderson LA, Ying J, et al. The BREASTrial:stage I. Outcomes from the time of tissue expander and acellular dermal matrix placement to definitive reconstruction. Plast Reconstr Surg, 2015, 135(1):29e-42e.
18. Gaynor BG, Benveniste RJ, Lieberman S, et al. Acellular dermal allograft for sellar repair after transsphenoidal approach to pituitary adenomas. J Neurol Surg B Skull Base, 2013, 74(3):155-159.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF VAGINOPLASTY WITH ACELLULAR DERMAL MATRIX AND MIXED PARTICLES GRAFT

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content