Ileocecal vaginal construction.

In 10 patients, six with previously failed vaginal reconstruction of Mayer-Rokitansky syndrome, two with male pseudohermaphroditism, one with a history of Wertheim-Meigs operation followed by irradiation of the true pelvis, and one with vaginectomy caused by trauma, a neovagina was created out of cecal or ileocecal segments. Advantages of this technique are the excellent blood supply to the ileocecal region and the long vascular pedicle. The supplemental application of terminal ileum for prolongation of the cecal vaginoplasty allows for tensionless anastomosis between the neovagina and the vulva, even in patients with difficult anatomic conditions. A detailed description of the operative technique and indications for ileocecal and cecal vaginoplasty are presented, and the techniques in current use for vaginal replacement are reviewed and discussed.