Vaginal Reconstruction in Gynecologic Oncology

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Abstract
The improved prognosis for patients with gynecologic malignancies has resulted in an increased concern for their sexual function. Vaginal reconstruction plays an integral role in this rehabilitation. The care of these patients at the University of Michigan is reviewed and their treatment is described. Fifty-one patients were treated with split-thickness skin graft vaginoplasty. Seven repeat vaginoplasties were required, for a total of 58 procedures. Fifty patients were assessed postoperatively, and 47 (94%) ultimately had a satisfactory outcome. Three of the 50 patients had an unsatisfactory final outcome; two had recurrent malignancy and the third patient did not comply with the proposed dilator regimen. Four patients developed fistulas. The split-thickness skin graft provides an acceptable outcome when used for vaginal reconstruction in the patient with a gynecologic malignancy.