Colocolpopoiesis : the use of sigmoid colon in the treatment of conditions associated with absence of the vagina

The creation of a coitally functional vagina is an important part of sexual rehabilitation in patients with congenital or acqnired absence of the vagina, and in male-to-female transsexuals. Various conservative and surgical techniques have been developed to construct an artificial vagina. Most of the operative techniques were based on the dissection of a cavity between the bladder and the recrum with subsequent grafting of various materials onto the walls of the 1llnnel. Nowadays, the most popular methods involve the lining of a surgically created rectovesical space with skin grafts. The major drawback is the stenosing tendency of the newly created channel. Life-long dilatations are required to assure its patency. The search for methods to construct a permanently patent neovagina has prompted surgeons to use various parts of the intestine to line the rectovesical cavity. It is assumed that an intestinal neovagina retains its immediate postoperative dimensions even without regularly performed dilatations, but the operative techniques are difficult and in the past, fatalities were reported.