An Overview of Vaginoplasty Techniques - Spotlight on the Efficacy of the Horseshoe Labia Minora Flap

Sep 28, 2026

Uploaded by dabgoudw

Background: Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome causes vaginal agenesis with variable uterine development and may coexist with renal, skeletal, or auditory anomalies. The study objective is to assess outcomes of multiple vaginoplasty methods aimed at creating a neovagina resembling natural anatomy to support normal sexual function. Methods: A retrospective review (2012–2024) evaluates McIndoe, Singapore flap, islanded pudendal flap, labia minora flap, and horseshoe labia minora modification. Outcomes are scored using vaginal length, introitus diameter, skin quality, and intercourse pain.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Introduction

Materials and Methods

Results

Conclusion

Article published online: 2025-06-12 454 Original Article THIEME An Overview of Vaginoplasty Techniques: Spotlight on the Efﬁcacy of the Horseshoe Labia Minora Flap Rasheedha Begum 1 Manimegala Philip 1 Mahadevan Kandasamy2 Sridevi Shanmugam3 Sugumar Muthachari 1 1 Department of Plastic, Reconstructive and Faciomaxillary Surgery, Madras Medical College, Chennai, Tamil Nadu, India 2 Department of Plastic and Reconstructive Surgery, Government Kilpauk Medical College, Kilpauk, Chennai, Tamil Nadu, India 3 Institute of Research and Rehabilitation of Hand and Department of Plastic Surgery, Stanley Medical College, Chennai, Tamil Nadu, India Indian J Plast Surg 2025;58:454–462. Address for correspondence Rasheedha Begum, MBBS, MS, MCh, Department of Plastic, Reconstructive and Faciomaxillary Surgery, Madras Medical College, Chennai 600003, Tamil Nadu, India (e-mail: [rasheedhabegum124@gmail.com](rasheedhabegum124@gmail.com)). Abstract Keywords ► vaginoplasty ► Mayer– Rokitansky– Küster–Hauser syndrome ► McIndoe procedure ► pudendal flap ► Singapore flap ► labia minora flap Background Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome involves vaginalagenesis and variable uterine development, often accompanied by renal, skeletal, and auditory anomalies. The primary objective of treatment is to reconstruct a neovagina that closely resembles the natural anatomy, enabling normal sexual function. This study evaluates various vaginoplasty techniques performed at our institution and their outcomes. Materials and Methods This retrospective study, conducted from January 2012 to January 2024, includes patients who underwent different types of vaginoplasty, including the McIndoe, Singapore ﬂap, islanded pudendal ﬂap, labia minora ﬂap, and horseshoe modiﬁcation of the labia minora ﬂap. Procedures were chosen based on clinical examination. Outcomes were assessed using an institutional scoring system evaluating vaginal length, introitus diameter, neovaginal skin quality, and pain during intercourse. Results Twenty patients of primary vaginal agenesis (aged 18–27) diagnosed clinically and conﬁrmed with pelvic MRI underwent vaginoplasty by the same surgical team. One (14.28%) patient of the McIndoe procedure experienced graft contracture, which was released and regrafted, while another (14.28%) had partial graft loss managed conservatively. No signiﬁcant complications occurred in the remaining patients. All used a postoperative vaginal mould for three months. The average follow-up period was 18 months, with neovaginal length ranging from 6 to 10 cm. Conclusion The horseshoe modiﬁcation of the labia minora ﬂap offers a reliable, effective approach for vaginal reconstruction in cases of MRKH syndrome. This technique fulﬁls the basic tenets of plastic surgery, namely the restoration of form and function. The simplicity of the procedure and relatively short learning curve render it an attractive ﬂap option even for the novice plastic surgeon. article published online June 12, 2025 DOI [https://doi.org/](https://doi.org/)[ ](https://doi.org/)10.1055/s-0045-1809412 . ISSN 0970-0358. © 2025 . The Author(s) . This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited.([https://creativecommons.org/licenses/by/4.0/](https://creativecommons.org/licenses/by/4.0/)) Thieme Medical and Scientiﬁc Publishers Pvt. Ltd. , A-12, 2nd Floor, Sector 2, Noida-201301 UP, India An Overview of Vaginoplasty Techniques Begum et al. 455 Introduction Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome is characterized by congenital vaginal absence and variable uterine development. It affects approximately 1 in 4,000 to 5,000 female births and may include renal, skeletal, or auditory abnormalities. Patients typically have a normal female phenotype, 46, XX karyotype, normal ov

FAQs

What patient condition and main treatment goal does the study address?

The study focuses on MRKH syndrome, characterized by congenital vaginal absence. The main treatment goal is reconstructing a neovagina that closely mimics natural anatomy to enable sexual function.

Which vaginoplasty techniques were evaluated in the retrospective study?

The study evaluated McIndoe, Singapore flap, islanded pudendal flap, labia minora flap, and a horseshoe modification of the labia minora flap.

How were outcomes measured after vaginoplasty?

Outcomes were assessed with an institutional scoring system evaluating vaginal length, introitus diameter, neovaginal skin quality, and pain during intercourse.

Sep 28, 2026

Uploaded by dabgoudw