A new technique of vaginal reconstruction with the deep inferior epigastric perforator flap: a preliminary report

Plast Reconstr Surg. 2007 May;119(6):1785-1790. doi: 10.1097/01.prs.0000259076.16918.fa.


Background: Vaginal reconstruction after tumor resection or in congenital vaginal agenesis remains a challenging area in surgery, with many techniques previously described underlining the continued search for an ideal method. In this preliminary report, a series of patients are presented who underwent vaginal reconstruction using a deep inferior epigastric artery perforator (DIEP) flap.

Methods: Between May of 2004 and February of 2005, five patients underwent vaginal reconstruction using the pedicled DIEP flap. Four patients had congenital vaginal agenesis and one had a complete vaginal resection because of a tumor.

Results: The flaps ranged in size from 9 x 10 cm to 11 x 12 cm. All flaps survived, although one patient developed a posterior space hematoma that required draining. Of the five patients, two were sexually active and enjoyed satisfactory penetrative intercourse after reconstruction.

Conclusions: This series demonstrates that a new vagina can be created from the pedicled DIEP flap and that the reconstruction is reliable, with low donor-site morbidity. The major disadvantage of this technique is the conspicuous abdominal scar.

MeSH terms

  • Adult
  • Congenital Abnormalities / surgery
  • Epigastric Arteries
  • Female
  • Follow-Up Studies
  • Graft Rejection
  • Graft Survival
  • Humans
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / methods
  • Rectus Abdominis / blood supply
  • Rectus Abdominis / transplantation*
  • Risk Assessment
  • Surgical Flaps / blood supply*
  • Vagina / abnormalities*
  • Vagina / surgery
  • Vaginal Neoplasms / surgery*