Evaluation of Pudendal Thigh (Singapore) Flap Vaginoplasty for Acquired Gynatresia: A Retrospective Study from Enugu, Nigeria.

BACKGROUND: Acquired gynatresia is an exhausting condition that affects sexual and reproductive health. Vaginoplasty using a bilateral pudendal thigh flap provides a good functional outcome. AIM: To evaluate the demographic data, clinical characteristics, and surgical outcomes of vaginoplasty using pudendal thigh flaps in patients with acquired gynatresia managed in Enugu, Nigeria. METHODS: The study was a retrospective study of patients with acquired gynatresia who underwent vaginoplasty in Enugu from January 2 nd , 1999, to December 31 st , 2024. Data retrieved included patient demographics, etiology, degree of stenosis, perioperative details, and functional outcome. Descriptive statistics were used in data analysis, and the functional outcome was assessed. The vaginal assessment was based on the ease of penetration and coital pain/discomfort despite the use of lubricant. RESULTS: A total of 19 patients were seen and treated. The mean age was 38.74 ± 4.62. Herbal pessary (17, 89.5%) was the predominant cause of gynatresia. Vaginal assessment scores increased from 0 during preoperative assessment to a mean score of 69.2 ± 7.9, with a range from 55 to 80 in the postoperative stage. Patients were followed up for at least 6 months. CONCLUSION: Vaginoplasty using pudendal thigh flaps is a reliable procedure for the effective management of acquired gynatresia, producing a functional outcome, that is, painless coitus and resumption of menstrual flow.