Bilateral transposition flaps for vaginal atresia reconstruction

Vaginal atresia is often detected due to pain or a mass in the lower abdominal region caused by retention of menstrual blood or secretions in the uterine tube, uterus, and vagina. We encountered a patient with vaginal atresia who presented due to menstrual molimina. She had undergone fenestration of vaginal orifice, but developed atresia again. Therefore, she was referred to our department and underwent vaginal orifice plasty with local flaps. A transposition flap was elevated lateral to each of the labia majora. After opening the closed vaginal orifice, the flaps were transposed to the mucosal defects. After the operation, the vaginal orifice did not develop re-stenosis and showed good distensibility. There was also no problem regarding menstrual blood discharge. This surgical procedure using local flaps may be useful since it is minimally invasive, can readily enlarge the vaginal orifice, and does not require additional postoperative treatments for the prevention of re-stenosis.

Level of Evidence: Level V, therapeutic study.