Tissue expansion vaginoplasty for treatment of congenital vaginal agenesis

Background: A patient with congenital vaginal agenesis was unsuccessful in the use of dilation to create a vaginal orifice and rejected the option of a buttock graft. Case: Two tissue expanders were introduced beneath the labia majora bilaterally and slowly expanded over 4 weeks. Redundant labial tissue was advanced as a bipedicle flap to line the neovagina created intraoperatively. Postoperative stent placement and dilation resulted in a vaginal canal lined by full-thickness mucosa exceeding 8 cm in depth. Conclusion: A modified method of tissue expansion vaginoplasty using a bipedicle flap is an option for the surgical creation of a vaginal orifice.