Reconstruction of Vagina with Bilateral Pudendal Thigh Flap: A Solution for Atresia/ Agenesis of Vagina

Reconstruction of vagina is a technically challenging surgery. The aim is to create a functionally and aesthetically satisfactory neovagina in a way that will be reliable and suitable for most patients. Use of bilateral Pudendal thigh flap to create a neovagina may overthrow the conventional methods as there is no necessity for postoperative dilation or vaginal intercourse to maintain adequate vaginal length and diameter. Vaginal reconstruction was done with bilateral Pudendal thigh flaps, in seven patients with vaginal agenesis, during 2 years, from July 2021 to June 2023. This method of vaginoplasty is simple, safe, and reliable and has shown satisfactory functional and cosmetic results. The reconstructed vagina has a natural angle and is sensate in its lower part. No postoperative stenting or dilatation is required. The donor site can be closed primarily and the scar is well hidden in the groin crease.