Vaginal reconstruction with the Abbè-McIndoe technique: from dermal grafts to autologous in vitro cultured vaginal tissue transplant.

Vaginal agenesis represents the most common anomaly of the lower female genital tract. Surgical treatments have gradually evolved from aggressive procedures to minimally invasive techniques. The Abbè-McIndoe procedure is one of the most frequent surgical procedures used. The original Abbè-McIndoe procedure consisted of the surgical creation of a vagina in between the bladder and the rectum and the successive lining with a dermal graft. In the last decades different authors have introduced several modifications, mostly changing the lining material. Amniotic membranes, inert materials, and oral mucosa have all been used to improve the short- and long-term results. Recently, we have reported the use of autologous in vitro grown vaginal tissue as lining material with highly promising results. In this review, we discuss the improvements achieved using this minimally invasive procedure and discuss the advantages and disadvantages of the different materials.