Back to 2025 Abstracts
Use of Tunica Vaginalis for Neovaginal Canal Lining in Penile Inversion Vaginoplasty
Bernice Yu
*, Ehud Flis, Ethan Fung, Jacquelyn Roth, Peter Shamamian, Elan Horesh, Bella Avanessian, Jess Ting
Mount Sinai, Philadelphia, PA
Background:
Penile Inversion Vaginoplasty (PIV) traditionally relies on full-thickness scrotal skin grafts (SSG) to construct the neovaginal canal. The tunica vaginalis, conventionally used as a vascularized flap for urethral reconstruction, represents a viable adjunct. This study is the first to compare functional and safety outcomes of neovaginal canal lining using a tunica vaginalis and scrotal skin graft construct versus the traditional scrotal skin graft only in PIV.
Methods:
Data was collected on patients aged 18 and older who underwent PIV between January 2019 and February 2025. Primary exposure was defined by use of either a tunica vaginalis and scrotal skin graft construct (TV-SSG) or a full thickness scrotal skin graft (SSG) only for neovaginal canal lining. Primary outcomes included intra-operative complications, wound healing complications, granulation tissue, dilation capabilities, loss of depth, stenosis, [JR1] revisions, reoperations, and readmissions. Comparative analysis assessed outcomes between graft type. Statistical significance was set to P < 0.05.
Results:
Of 650 PIV patients, 108 patients (16.6%) underwent SSG only and 542 (83.3%) underwent TV-SSG construct for neovaginal canal lining. Across the outcomes examined, patients in the TV-SSG group had fewer intraoperative complications (
2.8% vs. 7.4%, p=0.039), delayed wound healing (
21.3% vs. 10.7%, p=0.002), granulation tissue (20.1% vs 31.5%, p=0.009), and graft failure requiring intervention (0.4% vs 2.8%, p=0.035) compared to the SSG only group. Additionally, loss of depth was observed in 9.6% of the TV-SSG group compared to 16.0% of the SSG only group, a difference that trended towards statistical significance (p = 0.058). Rates of readmission, reoperation, neo-vaginal stenosis and revision surgeries were comparable between groups.
Conclusion:
The present study supports the use of the tunica vaginalis as a safe adjunct and potentially superior alternative to scrotal skin grafts only for PIV neovaginal canal lining.
Table 1: SSG vs TV-SSG Outcomes
Back to 2025 Abstracts
