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case_images: Findings before the operation no pubic hair was observed and the vagina measured 3 cm. The vaginal vestibule narrowed on the anal side.
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case_images: The vagina measured 3 cm and there was a coecum, while the vaginal vestibule narrowed on the anal side (Figure 1).
case_images: Findings of transvaginal ultrasonography the uterus was absent and the distance from the tip of the vaginal caecum to the retroperitoneum was 2.7 cm.
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case_images: Design of PTF the bilateral skin flaps were extended towards the anal side, thereby reconstructing the vaginal vestibule using these parts.
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case_images: Moreover, the bilateral skin flaps were extended towards the anal side, thereby reconstructing the vaginal vestibule using these parts (Figure 3).
case_images: Harvesting PTF.
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case_images: The bilateral PTFs were elevated under the fascia (Figure 4), a tunnel was made underneath the skin of the outer labia, and subsequently, these skin flaps were moved to the centre (Figure 5).
case_images: Moving PTF to the centre.
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case_images: The bilateral PTFs were elevated under the fascia (Figure 4), a tunnel was made underneath the skin of the outer labia, and subsequently, these skin flaps were moved to the centre (Figure 5).
case_images: Creating an intravaginal cavity.
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case_images: Next, the skin flaps were sutured together from the distal part of the skin flap in the shape of a lumen, thereby creating an intravaginal cavity (Figure 6).
case_images: Post operation (a) a vertical incision was made in the narrowed vaginal vestibule of the anal side and part of the anal side of PTF was inserted. (b) The donor site was temporarily reefed along the contour line of the inner proximal region of the thigh.
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case_images: Moreover, in order to make the vaginal vestibule, a vertical incision was made in the narrowed vaginal vestibule of the anal side along with the remaining vaginal mucous membrane and subsequently, part of the anal side of the skin flap was inserted (Figure 7(a)). The donor site was temporarily reefed along the contour line of the inner proximal region of the thigh (Figure 7(b)).
case_images: (a) Two years and four months following surgery. No stenosis of the vaginal vestibule or opening of the vagina was observed. (b) Two years and four months following surgery. No stenosis of the vaginal vestibule or opening of the vagina was observed.
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case_images: No stenosis of the vaginal vestibule or opening of the vagina was observed (Figure 8(a)) and a substantially satisfactory vulva shape was thereby acquired (Figure 8(b)).