PFD Week 2017-Rectovaginal Fistula Repair Using a Gracilis Muscle Flap and Full Thickness Skin Graft

Rectovaginal Fistula Repair Using a Gracilis Muscle Flap and Full Thickness Skin Graft

Video Transcription

Video Summary

In this video, a 30-year-old African-American female with Meyer-Rokitansky-Kuster-Hauser syndrome is presented. She previously underwent a failed McIndoe vaginoplasty and developed necrotic vaginal lesions and a rectovaginal fistula from consistent use of a vaginal mold. The patient's diagnosis, MRKHS, is a congenital absence of a vagina with incomplete uterine development. Self-dilation is the preferred initial treatment, but the patient declined and underwent a gracilis muscle flap reconstruction. The gracilis muscle was harvested and transposed to the vaginal area to cover the fistula. A full thickness skin graft was placed over the flap. Five months after surgery, the fistula is healed, and the patient has a 5.5 cm neovagina and is using it for intercourse successfully.

Asset Subtitle

Bobby Allen Garcia, MD

Meta Tag

Concept Müllerian Agenesis

Concept McIndoe Vaginoplasty

Concept Vaginal Agenesis

Concept Gracilis muscle flap

Concept Rectovaginal Fistula

Keywords

African-American female

Meyer-Rokitansky-Kuster-Hauser syndrome

McIndoe vaginoplasty