Free microvascular transfer of the vermiform appendix and colon for creation of a uterovaginal fistula: a new technique for cervicovaginal reconstruction

Objective: To report a new technique for creating a uterovaginal fistula in a patient with vaginal dysgenesis, an atretic cervix, and a functional endometrium. Design: Case report. Setting: University tertiary care hospital. Patient(s): A patient with an atretic cervix, dysplastic vagina, and a functional uterus. Intervention(s): Creation of a neocervix by partial resection of the septum within a didelphic uterus and an uterovaginal fistula by the free microvascular transfer of a vermiform appendix and an 8-cm segment of ascending colon. Main Outcome Measure(s): Clinical follow-up examination to verify restoration of the outflow of menstrual blood and patency of the uterovaginal fistula. Result(s): The patient commenced menstrual bleeding 8 weeks postoperatively, after which she had regular menstrual cycles. The uterovaginal fistula was patent at the 3-year follow-up examination. Conclusion(s): Free microvascular transfer of the appendix and ascending colon for creation of an uterovaginal fistula is an improved and superior technique for cervicovaginal reconstruction, with excellent long-term results.