Bilateral rotated buttock flaps for vaginal atresia in severely masculinized females with adrenogenital syndrome.

The addition of large bilateral rotated buttock flaps to the flap vaginoplasty enhances the introitus in severely masculinized patients with high vaginal atresia. The flaps are rotated medially to create the distal aspect of the lateral and anterior vaginal wall. The inferior advancement of the labioscrotal folds aids in closing the donor defect, while at the same time creating the appearance of labia majora. Finally, the use of these local tissues will result, in later life, in a vaginal reconstruction free of unwanted hair. This reconstruction technique should obviate dilatation in the older child and prevent further stenosis.