Congenital absence of the vagina. A clinical, histological and histochemical study on 17 patients with graft-constructed vaginas.

During a ten-year period 17 patients with total congenital absence of the vagina were treated by a split-skin inlay grafting technique. The average age at the time of operation was 21 years. Associated malformations, mostly afflicting the urinary tract, were found in 9 patients. The skin graft was applied on a perforated hollow acrylic mould, 12 cm long and 4 cm in diameter. The acrylic mould was removed on the tenth day and a soft silicon mould was then utilized for at least 6 months. The mean hospitalization time was 28 days. The grafts took completely in 11/17 patients and in the remaining cases the take averaged 80%. There was no major complication, such as fistulas, in the series. With the exception of two patients with male hermaphroditism all patients were contented with the operation and stated that they had a satisfactory sex-life. In 9/17 patients, a closer follow-up including a biopsy was made. The average depth of the vaginas was 8 cm (range, 6 to 10 cm), and the average diameter 3 cm (range 2.5 to 4 cm). The histological studies consistently showed that the original skin morphology was maintained in the recipient site.