Vaginal scar stricture repair using a U-shaped mucosal flap
Glukhov E.Yu., Neff E.I., Kuznetsov V.V., Kurkova T.F., Glukhova V.E., Khizadze A.G., Dikke G.B.
Background: Vaginal stenosis (gynatresia) is an undesirable outcome of pelvic floor surgeries or diseases and injuries of the perineum and vagina with a frequency of 5.8% to 42%. It is characterized by genito-pelvic pain/penetration disorders, which are associated with adverse psychological, reproductive, sexual and marital consequences.
Case report: This paper presents two clinical cases of surgical treatment of patients suffering from postoperative vaginal stricture, manifested as annular cicatricial deformity of the perineum, vestibule, and posterior vaginal wall. In the first case, the pathological condition arose as a result of surgical overcorrection of pelvic organ prolapse with excessive excision of the mucous flap of the posterior vaginal wall. In the second case, it arose as a result of 12 surgical interventions for multiple congenital malformations. The tactics we developed and used for the first time consisted in excision of scar tissue, followed by dissection and surgical transposition (displacement) of a U-shaped mucosal flap from the proximal posterior vaginal wall to its distal portion to close the resulting tissue deficit and widen the vaginal lumen. The use of electrosurgical radio wave technologies and adequate postoperative wound care resulted in a positive outcome and avoided purulent-inflammatory complications.
Conclusion: The surgical correction of postoperative vaginal stenosis by displacing a U-shaped vaginal mucosal flap is a promising alternative to existing treatment methods and requires further study.
Authors’ contributions: Glukhov E.Yu. – organization of the study and its supervision, performing surgery, editing the first version of the article; Neff E.I., Khizadze A.G. – literature analysis, review of publications on the topic, writing the first version of the article; Kuznetsov V.V., Kurkova T.F., Glukhova V.E. – collecting and describing the clinical data, analysis, interpretation of the results; Dikke G.B. – editing the text, editing the article after peer review. All authors guarantee the accuracy of all parts of the work and approved the final version of the article.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The study was conducted without sponsorship.
Patient Consent for Publication: The patients provided an informed consent to the publication of their data and images in an impersonal form.
For citation: Glukhov E.Yu., Neff E.I., Kuznetsov V.V., Kurkova T.F., Glukhova V.E., Khizadze A.G., Dikke G.B. Vaginal scar stricture repair using a U-shaped mucosal flap.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (2): 166-174 (in Russian)
https://dx.doi.org/10.18565/aig.2026.03
Keywords
postoperative cicatricial vaginal stenosis
vaginal stricture
surgical treatment
vaginoplasty
dyspareunia
pelvic dysfunction
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Received 13.01.2026
Accepted 10.02.2026
About the Authors
Evgeny Yu. Glukhov, Dr. Med. Sci., Chief Physician, CRG «Zhenskaya klinika», 620137, Russia, Yekaterinburg, Botanicheskaya str., 19; Professor of the Department of Obstetrics and Gynecology with a Course in Medical Genetics, Ural State Medical University, Ministry of Health of Russia, 620028, Russia, Yekaterinburg, Repina str., 3, 9222241411@mail.ru, https://orcid.org/0000-0003-3899-8382Ekaterina I. Neff, PhD, Deputy Chief Physician for Medical Affairs, CRG «Zhenskaya klinika», 620137, Russia, Yekaterinburg, Botanicheskaya str., 19; Assistant at the Department of Obstetrics and Gynecology with a Course in Medical Genetics, Ural State Medical University, Ministry of Health of Russia, 620028, Russia, Yekaterinburg, Repina str., 3, neff1974@mail.ru, https://orcid.org/0009-0000-5312-1007
Viktor V. Kuznetsov, obstetrician-gynecologist, CRG «Zhenskaya klinika», 620137, Russia, Yekaterinburg, Botanicheskaya str., 19, 79220317537@yandex.ru,
https://orcid.org/0009-0006-5608-7274
Tatiana F. Kurkova, obstetrician-gynecologist, ultrasound physician, CRG «Zhenskaya klinika», 620137, Russia, Yekaterinburg, Botanicheskaya str., 19, kurkovagyn@ya.ru, https://orcid.org/0009-0009-6360-9044
Victoria E. Glukhova, obstetrician-gynecologist, Head of the Ultrasound Diagnostics Department, CRG «Zhenskaya klinika», 620137, Russia, Yekaterinburg,
Botanicheskaya str., 19, gluhovav17@mail.ru, https://orcid.org/0009-0006-1656-5411
Artem G. Khizadze, obstetrician-gynecologist, CRG «Zhenskaya klinika», 620137, Russia, Yekaterinburg, Botanicheskaya str., 19, khizadze.artem@gmail.com,
https://orcid.org/0009-0006-9542-5184
Galina B. Dikke, Dr. Med. Sci., Professor, Department of Obstetrics and Gynecology with a Course of Reproductive Medicine, F.I. Inozemtsev Academy of Medical Education, 190013, Russia, St. Petersburg, Moskovskiy Ave., 22 Liter M, galadikke@yandex.ru, https://orcid.org/0000-0001-9524-8962
Corresponding author: Evgeny Yu. Glukhov, 9222241411@mail.ru
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