An Improved Method for Vaginoplasty

During the past six years at the University of Cincinnati Medical Center, we have employed a modification of our standard procedure for vaginoplasty for correction of a congenital urogenital sinus. The technique permits suturing the vaginal mucosa to the skin without tension, creating an adequate vaginal orifice. A triangular skin flap is developed and rotated into a corresponding incision in the urogenital sinus and posterior vaginal wall. The skin flap thus becomes a part of the posterior wall of the vagina. The technique has been employed for 12 children. Nine had congenital adrenal hyperplasia. Three were type 2 female pseudohermaphrodites. A satisfactory vaginal orifice was created in each instance and there were no complications. Technique With the patient under general anesthesia and in the lithotomy position, the perineum is prepared with soap and water and painted wth aqueous benzalkonium chloride (Zephiran) (Fig 1). A curved hemostat is inserted into the