Endoscopic colposigmopiesis technique for surgical correction of the perineum in patients with congenital absence of the vagina

Purpose of a study: to present a surgical technique based on the accumulated clinical experience in performing reconstructive plastic surgeries on the perineal organs in patients with congenital vaginal aplasia and in patients diagnosed with gender dysphoria.

Material and methods. More than 10 perineal reconstructive surgeries using a segment of the sigmoid colon and employing endoscopic techniques were performed at the I.M. Sechenov First Moscow State Medical University (Sechenov University) and at Clinic of the Family Medical Centers Network LLC in the period of 2021–2023. Postoperative outcomes were assessed based on physical examination findings, patient-reported satisfaction with the surgical results, and radiologic studies in 1 and 2 weeks, as well as in 1, 2, 4, and 6 months after surgery.

Results. The study resulted in the development of a structured algorithm and a detailed description of the vaginal reconstruction technique using sigmoid colpopoiesis. The described technique provides a long-term, aesthetically and physiologically successful outcome, as confirmed by objective assessment methods and patient-reported feedback.

Conclusion. Vaginoplasty using sigmoid colpopoiesis a relevant, promising, and highly advanced method for female genital reconstruction, enabling the creation of a neovagina that is anatomically and functionally as close as possible to the natural structure.

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