Hysteroplasty and vaginoplasty for reconstruction of the uterus.

A simple surgical procedure for reconstruction of the uterus from available Müllerian bulbs with simultaneous vaginoplasty is described. The Müllerian bulbs on both sides are incised, and suitable central fibromuscular tissue is excised to make a uterine cavity. The margins are sutured around a uterine mold, taking care to leave tubal os free. The reconstructed lower end of the uterus (now representing the cervix and upper third of the vagina) is brought down into the space already made out of the peritoneal septum between the bladder and the rectoanal region. The perineal operation for vaginoplasty is completed after suturing the lower end of the reconstructed uterus to the upper margin of the reconstructed vagina. The vaginal and uterine molds are kept in place for one and two weeks postoperatively, respectively.