Use of autologous buccal mucosa for vaginoplasty: a study of eight cases

Department of Obstetrics and Gynecology, China Medical College Hospital, No. 2 Yuh-Der Road, Taichung 404, Taiwan.
Human Reproduction (Impact Factor: 4.59). 04/2003; 18(3):604-7. DOI: 10.1093/humrep/deg095
Source: PubMed

ABSTRACT Vaginal agenesis is a rare condition and treatment methods are varied. The difference between most of the surgical techniques is the graft material used. The purpose of this study was to describe the procedure and outcome of creating a neovaginal pouch lined with autologous buccal mucosa.
Between August 2000 and February 2002, eight patients with Mayer-Rokitansky-Kuster-Hauser syndrome were admitted to our hospital. All of the patients successfully underwent neovaginoplasty with autologous buccal mucosa as graft material. The buccal mucosal wound completely healed 2 weeks after the operation and the neovaginal length and calibre were well formed. Follow-up ranged from 0.5 to 1.5 years. One patient encountered post-operative vaginal bleeding and another patient suffered from urinary bladder injury.
This is the first reported procedure of vaginoplasty with autologous buccal mucosa as graft material. Our method is ideal in its simplicity, provides good cosmetic results, and improves the vaginal length of the patient.

Download full-text


Available from: Cherry Yin-Yi Chang, Jun 29, 2015
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Acoustic microscopy was used to monitor an ex vivo produced oral mucosal equivalent (EVPOME) developed on acellular cadaveric dermis (AlloDerm®). As seeded cells adhered and grew, they filled in and smoothed out the surface irregularities, followed by the production of a keratinized protective outermost layer. If noninvasive in vitro ultrasonic monitoring of these cellular changes could be developed, then tissue cultivation could be adjusted in-process to account for biologic variations in the development of these stratified cell layers. Cultured keratinocytes (from freshly obtained oral mucosa) were harvested and seeded onto AlloDerm® coated with human type IV collagen and cultured 11 days. EVPOMEs were imaged on the 11th day post-seeding using a scanning acoustic microscope (SAM) that consists of a single-element transducer: 61 MHz center frequency, 32 MHz bandwidth, 1.52 f-number. The specimen surface was determined by thresholding the magnitude of the signal at the first axial incidence of a value safely above noise: 20-40 dB above the signal for the water and 2-dimensional (2-D) ultrasonic images were created using confocal image reconstruction. A known area from each micrograph was divided into 12-40 even segments and examined for surface irregularities. These irregularities were quantified and one-way analysis of variance (ANOVA) and linear regression analysis were performed to correlate the surface profiles for both the AlloDerm® and EVPOME specimens imaged by SAM. Histology micrographs of the AlloDerm® and EVPOME specimens were also prepared and examined for surface irregularities. Unseeded AlloDerm® averaged seven to nine surface changes per 400 μm. The number of changes in surface irregularities decreased to two to three per 400 μm on the mature EVPOMEs. The numbers of surface irregularities between the unseeded AlloDerm® vs. developing EVPOME are similar for both histology and SAM 2-D B-scan images. For the EVPOME 2-D B-scan micrographs produced by SAM, the decrease in surface irregularities is indicative of the stratified epithelium formed by seeded oral keratinocytes; verified in the histology images between the AlloDerm® and EVPOME. A near 1:1 linear correlation shows the similarities between the two imaging modalities. SAM demonstrates its ability to discern the cell development and differentiation occurring on the EVPOME devices. Unlike histology, SAM measurements are noninvasive and can be used to monitor tissue graft development without damaging any cells/tissues.
    Ultrasound in medicine & biology 08/2011; 37(10):1734-42. DOI:10.1016/j.ultrasmedbio.2011.06.010 · 2.10 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Vaginal agenesis is an uncommon, but not rare, condition. Although there are many methods for creating a neovagina, the optimal treatment is unknown. An 18-year-old woman with Mayer-Rokitansky-Küster-Hauser syndrome received vaginoplasty with a modified Wharton procedure using an artificial dermis (atelocollagen sponge). From 10 days after the operation, the patient was administered human recombinant basic fibroblast growth factor (bFGF) spray to accelerate epithelialization on the neovagina. At 50 days after the operation, we confirmed histological squamous epithelialization of the vaginal epithelium. At 12 months after the operation, the neovagina was at least 3.5 cm in width and approximately 8 cm in length. In this case, use of artificial dermis and recombinant bFGF to create a neovagina was an easy, less invasive and useful method.
    Human Reproduction 08/2004; 19(7):1629-32. DOI:10.1093/humrep/deh254 · 4.59 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Female genital tract malformations are frequently a cause of reproductive problems. Besides, complex malformations also frequently generate serious gynecological problems, often ones with inappropriate surgical solutions, as the gynecologist does not think of the malformation as either the cause of the symptoms or of its embryonary origin. Apart from analyzing the embryological bases in the development of the female genital tract and insisting on the well known müllerian origin of the uterus, the ratification of the embryological hypothesis about the origin of the human vagina from the Wolff ducts and the Müller tubercle allows us to not only advance in knowledge but to use that knowledge for better clinical management of the problems generated by the complex malformations of the female genital tract. In this review we study the methods and means for the diagnosis of female genital-urinary malformations, their classification and clinical findings, and especially those cases involving unilateral renal agenesis, vaginal ectopic ureter and other complex malformations. We also analyze the related obstetric and gynecologic pathology, and especially that cases of complex genital malformations. We review the related literature and some interesting case reports, as well as our experimental studies in rats. After re-asserting our hypothesis about the embryology of the human vagina as derived from the Wolff ducts and the Müller tubercle, we suggest different recommendations for a better approach and management of the malformations of the female genital tract according to the findings observed in different diagnostic procedures.
    Current Women s Health Reviews 11/2007; 3(4). DOI:10.2174/1573404810703040248