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.