Comparison of graft materials used in the McIndoe procedure in terms of anatomical and sexual function in a tertiary care hospital and a brief overview of vaginoplasty techniques.

OBJECTIVES: Vaginal agenesis is one of the most common causes of primary amenorrhea. Creating a vagina that allows coitus is a necessary procedure for the psychological and social well-being of these patients. For this purpose, McIndoe method is the most frequently used method. Various materials are used as grafts in this surgery. In this study, the aim was to compare the amnion and skin grafts that are used in the McIndoe method.

MATERIAL AND METHODS: Between 2011 and 2021, 12 patients were operated on using the McIndoe method. Chromosomal analysis, operation times, preoperative and postoperative vaginal lengths and complications were evaluated. Sexual function of the patients was evaluated with the Female Sexual Function Index (FSFI) questionnaire.

RESULTS: Skin was used in seven patients and amnion was used in five patients. Chromosomal anomaly was detected in two patients. Operation times were significantly shorter in the group with amnion grafts. Postoperative tissue infection developed in one patient. In the evaluation at the end of the first year, it was observed that vaginal stenosis developed in two patients in whom amnion was used. Vaginal lengths were longer in skin group (8.7 ± 1.1 cm vs 5.4 ± 2.5 cm). Nine patients had active sex life. Female Sexual Function Index score was 30.3 ± 5.8 in skin group n = 6 and 27.9 ± 5.5 in amnion group n = 3 which was evaluated as normal.

CONCLUSIONS: The most used method for vaginoplasty is McIndoe. There is no consensus on the ideal material for grafting. Regardless of which graft is used, regular usage of the dilator is the cornerstone of this procedure.