Outcomes of pudendal thigh flaps in the reconstruction of vaginal agenesis: A tertiary care experience

This study evaluated the outcomes of using islanded pudendal thigh flaps for neo-vaginal reconstruction in 23 patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, aged 13 to 19 years. The results showed a 100% flap survival and patency rate, with the flaps being sensate and erogenous but lacking mucus secretion. The neo-vagina could easily admit two fingers, and hair growth was observed in the posterior vaginal wall in 8.7% of cases. The technique effectively increased the surface area of the vestibule and prevented stenosis, demonstrating that the vascularity of the flap remained unaffected even when islanded on a subcutaneous pedicle including the perforator.