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Colovaginoplasty in infants and children.

OBJECTIVE
To develop a technique of vaginoplasty suitable for use in children with vaginal insufficiency, without the need for lubrication and regular dilatation. Enteric segment vaginoplasty, previously reported in adolescents and adults, does not require dilatation and has growth potential unlike current methods, involving skin flaps or free grafts.


PATIENTS AND METHODS
We report the use of a segment of sigmoid colon in seven consecutive children (age range 4 months to 16 years). The diagnoses included congenital adrenal hyperplasia (1), androgen insensitivity syndrome (3), and vaginal agenesis (3).


RESULTS
The mean post-operative hospital stay was 8 days (6-10 days) and there was no peri-operative mortality or morbidity. At follow-up examination all children had an excellent cosmetic appearance without excessive mucus discharge. The oldest two girls required finger dilatation for mild colocutaneous stenosis.


CONCLUSION
The surgery was completed before the age of 16 months in the three cases referred early. Though the follow-up is short it is hoped that this will minimize the emotional disturbance suffered by the child and parents faced with this problem. We have found colovaginoplasty to be a technically straightforward procedure with minimal morbidity suitable for use in infants and children. We await long-term follow-up to confirm this procedure to be the operation of choice in paediatric patients.