Marcelo Praxedes Monteiro Filho*, Berenice Bilharinho de Mendonca, Alessandro Tavares, Francisco Tibor Dénes and Maria Helena Palma Sircili
Department of Surgery, University of São Paulo, BrazilFulltext PDF
Introduction: The most used technique for neovaginoplasty in transsexual women is the "penile inversion technique". This technique is mostly successful, but there can be complications resulting in loss of the neovagina. New techniques with buccal mucosa graft have been used to correct complications such as rectovaginal fistulas. Buccal mucosa combined with posterior scrotal flap transfer has also been proved to be an option to create a functional neovagina.Aim: Describe a case of a transgender patient who underwent a successful redo neovaginoplasty with buccal mucosa graft after the early loss of the penile skin neovagina.Methods: Information was collected through a review of the patient's chart from the year 2001 until 2018.Results: Feminizing genitoplasty with “penile inversion” technique was first performed in a transgender patient at age of 34. Due to surgical complications, the patient underwent a new procedure to correct a rectalvaginal fistula and was left with a 2 cm deep neovagina. After a year of dilation, without success, the creation of a new neovagina with buccal mucosa graft was performed. Two mucosal grafts of 3 cm × 6.5 cm were used creating a 7 cm × 1.5 cm neovagina. After two years of dilation the patient was able to use an acrylic mold of 10 cm × 3 cm. After 6 years of follow-ups the neovagina is 11 cm long and allows the introduction of a medium vaginal speculum and a 10 cm × 3 cm rigid mold. Patient has not yet started sexual activity.Conclusion: The use of buccal mucosa for neovaginoplasty is technically easy, has good aesthetic results and low risks of complications. This technique allows the creation of a cosmetically and functionally adequate neovagina with a mucosa similar of that normal vaginal tissue. It may be a good alternative for patients with a short neovagina or with loss of the primary neovagina.
Filho MPM, de Mendonca BB, Tavares A, D�nes FT, Sircili MHP. Successful Buccal Mucosa Graft for Salvage of Neovaginoplasty in a Transgender Patient: Case Report and Six Years Follow-Up. Clin Surg. 2019; 4: 2326.