Autologous buccal mucosa graft for primary and secondary reconstruction of vaginal anomalies

Adult and pediatric urologists, gynecologists, and surgeons are often faced with primary reconstruction of complex congenital defects of the vagina as seen in cloacal anomalies, disorders of sexual development (DSD), and vaginal agenesis as well as with the secondary repair of post-surgical or radiation-induced vaginal stenosis or foreshortening. Many options have been reported and the choice of a particular method is influenced by surgeon experience, regional trends, availability of multidisciplinary teams and many other social and age-related factors. No one option has become the solution for all patients of all ages and anatomical challenges. Here we discuss a newer approach that can be used as an option for bridging the gap in young patients with a long distance from the perineum to the vaginal structures, for total vaginoplasty in some cases of primary vaginal agenesis in adolescents or young adults, and for correction of stricture in patients who have undergone previous reconstructions. Our initial experience using autologous buccal mucosa for reconstructions on eight patients with varying diagnoses is retrospectively reviewed.