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

Keywords

African-American female

Meyer-Rokitansky-Kuster-Hauser syndrome

McIndoe vaginoplasty

rectovaginal fistula

gracilis muscle flap reconstruction