The split thickness graft technic for vaginal agenesis

A heterogenous group of patients with agenesis of the vagina treated at The Johns Hopkins Hospital between 1956 and 1975 is reported. The split thickness autogenous skin graft technic of Mclndoe was used in 44 patients with Rokitansky-Kuster-Hauser syndrome, 9 male hermaphrodites, 7 patients with the testicular feminization syndrome, and in 4 male transsexual patients. Urinary tract abnormalities were found in 49% of patients with the Rokitansky syndrome. The functional results were quite satisfactory. The graft was satisfactory in all but 3 patients who required a partial second skin graft. Rectovaginal fistula with spontaneous closure occurred in 1 patient, and a transsexual patient developed a urethrovaginal fistula which was repaired surgically. Better results with the take of the skin graft have been obtained since a foam rubber vaginal form has been used and routine prophylactic antibiotics administered. Severe condylomata acuminata of the neovagina developed in 3 patients.