The Modified McIndoe Technique: A Scar-free Surgical Approach for Vaginoplasty With an Autologous Micromucosa Graft

Abstract

Objective: To evaluate the effect of a scar-free surgical approach, the modified McIndoe technique, in cases of vaginal agenesis.

Materials and methods: Seven patients with Mayer-Rokitansky-Kuster-Hauser syndrome underwent vaginoplasty with the modified McIndoe technique. Mucosa grafts harvested from the vulva were minced into small particles and transplanted to the neovagina.

Results: Epithelization in the neovagina is approximately 20 times in size than that in the mucosa harvested from the donor site. An adequate vaginal length was obtained in all cases, with a minimal change in genital appearance and invisible scars. All 4 sex-active patients reported satisfactory sexual experiences, with spontaneous lubrication during intercourse.

Conclusion: With the modified McIndoe technique, using an autologous micromucosa graft harvested from the vulva and the buccal cavity, we can physiologically reconstruct a new mucosa-lined vagina with minimal sacrifice.