Local Perineal Capillary Perforator Flaps: A Minimally Invasive Technique for the Correction of Vulvar Stenosis

TL;DR

This paper introduces a minimally invasive surgical technique using capillary perforator flaps to effectively treat vulvar stenosis, resulting in significant improvement with no complications.

Contribution

The novel CPPF technique offers a safe and effective solution for vulvar stenosis correction with minimal invasiveness and no postoperative complications.

Findings

Thirteen patients experienced complete resolution of vulvar stenosis with no recurrences after CPPF surgery.

The average severity of stenosis improved significantly from 2.3 preoperatively to 0.3 postoperatively (p < 0.01).

No postoperative complications were observed in any of the patients treated with CPPF.

Abstract

Background: Vulvar stenosis is a debilitating condition that compromises sexual function, urination, and the ability to undergo gynecological examinations. The purpose of this study is to describe the technique of capillary perforator perineal flaps (CPPF) for the correction of vulvar stenosis. Methods: We retrospectively examined patients with vulvar stenosis treated through surgical separation and reconstruction with CPPF. The procedure involved vulvar separation with the creation of a subsequent defect, repaired using a flap, harvested laterally to the labia majora including a capillary perforator and transferred through a subcutaneous tunnel to repair the vulvar defect. The functional outcome was evaluated with the Bradford scale, comparing the preoperative and postoperative scores using the Student’s t-test. Results: thirteen patients were included, three with stenosis following treatment for vulvar cancer and ten due to lichen sclerosus. In total, we analyzed 29 flaps, with an average size of 15.6 cm2. We always included just one perforator in the flap and no postoperative complications. Stenosis was resolved in all patients, with no recurrences one year after the surgery. The preoperative average severity of the stenosis was 2.3 + 0.6, reducing to 0.3 + 0.4 post-intervention, indicating a significant improvement (p < 0.01). Conclusions: CPPF has proven to be a quick and safe method for the reconstruction of vulvar stenosis.

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