Treatment of vaginal stenosis with fasciocutaneous Singapore flap

Marisa M. Clifton, Raffi Gurunluoglu, Javier Pizarro-Berdichevsky, Todd Baker, Sandip P. Vasavada

Research output: Contribution to journalArticle

Abstract

Introduction: Vaginal stenosis is an unfortunate complication that can occur after pelvic radiation therapy for gynecologic or colorectal malignancies. Treatment is challenging and can require significant reconstructive surgery. The objective of this video is to present a case of vaginal stenosis after radiation and describe vaginal reconstruction with a fasciocutaneous Singapore flap. Methods: We describe the case of a 42-year-old woman with a history of stage 3 colorectal cancer who underwent partial colectomy, chemotherapy, and pelvic radiation. She subsequently developed a rectovaginal fistula requiring repair with a right-sided gracilis flap. When her stenosis recurred, she underwent vaginal reconstruction with a medial thigh flap. Results: The Singapore flap is a pudendal thigh flap centered on the labial crural fold with a base at the perineal body. As the cutaneous innervation is spared, this flap is sensate. This technique is one option for patients with complex vaginal stenosis who have failed conservative management. However, it is imperative the patient perform vaginal dilation postoperatively and maintain close follow-up with her surgeon, as vaginal stenosis can recur. Conclusions: Postradiation vaginal stenosis is a complex condition to treat; however, vaginal reconstruction with a thigh flap can provide excellent cosmetic and functional results.

Original languageEnglish (US)
Pages (from-to)493-495
Number of pages3
JournalInternational Urogynecology Journal
Volume28
Issue number3
DOIs
StatePublished - Mar 1 2017
Externally publishedYes

Keywords

  • Abnormalities
  • Dyspareunia
  • Flap
  • Pedicled
  • Radiation-induced
  • Reconstructive
  • Surgical procedure
  • Vaginal diseases

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Urology

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