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Year : 2020  |  Volume : 28  |  Issue : 2  |  Page : 123-126

Interposition of a unilateral singapore posteriorly based fasciocutaneous axial flap for treating rectoneovaginal fistula in a male-to-female trans-sexual patient

Inspira Health, Mullica Hill/Vineland, New Jersey; Icahn School of Medicine at Mount Sinai, New York, USA

Correspondence Address:
Dr. Woojin Chong
Urogynecology at Inspira Health, 2950 College Drive Suite 2A, Vineland, New Jersey, 08360
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjps.tjps_44_19

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Rectoneovaginal fistula (RnVF) is one of the major complications for the gender reassignment surgery. Closure of the RnVF with interposition of a pedicled tissue flap is a useful surgical approach to reconstruct the perineal space and provide neovascularization. Martius flap, gracilis muscle flap, and Singapore flap are the options of pedicled tissue flap. An HIV-positive 37-year-old male-to-female trans-sexual patient presented with a large RnVF (8–9 cm × 4 cm) after penile inversion vaginoplasty. A modified Singapore flap was performed to repair RnVF and to reconstruct the perineal space. Vaginal reconstruction with a fasciocutaneous Singapore flap can be considered for male-to-female trans-sexual patients with a complex RnVF as it provides excellent neovascularization with a sensate flap and desirable cosmetic outcome.

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