WOFAPS 2025 8th World Congress of Pediatric Surgery

Mahmoud Tarek, Hend Mehawed, Ahmed kadri, Khaled Bahaa Eldin

Cairo University Faculty of Medicine, Pediatric Surgical Division, Cairo University Specialized Pediatric Hospital, Egypt

Introduction:

Surgeries to correct ambiguous genitalia are directed mainly towards

creating a dilatable vagina allowing proper sexual function,

removal of redundant erectile tissues and labioplasty. (6)

The depth of the confluence from the perineum is important

indicator of the need of urogenital mobilization and can be well measured using genitography.

The Present study aimed at evaluation of using a tubular flap from the

inner face prepuce for vaginoplasty. Flap pliability and vascularity

were the desired features of the constructed flap.

Methods:

Non-controlled prospective clinical trial with all patients included in single group, this technique used alone in low and intermediate depth of confluence or in combination with laparoscopic vaginal mobilization in cases of high confluence, the inner surface of the prepuce was fashioned as a tube and anastomosed to the vagina inside forming all walls of the vagina after partial urogenital mobilization.

Results:

We operated upon 12 cases, ages ranges from 24 months to 73 months, all cases had 46 XX, seven cases were salt losing type and five cases were simple virilizing type. Half of our cases (50 %) were classified Prader IV and approximately 83% (significant portion) comprise cases with Prader III and Prader IV. Follow up revealed satisfactory results with easily dilatable new vagina, only one case of vaginal stenosis well responded to dilatation.

Conclusion:

Using inner surface of the prepuce as a pedicled flap in creating a vaginal tube is an applicable promising technique with good results, giving a solution to the problem of vaginal stenosis.