Aim & Objectives: The surgical management of the vaginal agenesis is a complex problem and constitutes a significant technical challenge. The aim is to create a neovagina that is satisfactory both functionally and aesthetically using a technique that is simple, reliable, and applicable to most patients.

Materials & Methods: Twenty patients were opted for this prospective observational study conducted in the Department of Plastic Surgery, Dhaka Medical College and Hospital (DMCH), Dhaka over a period of one year from September 2014 to August 2015. All patients with congenital absence of vagina were selected for surgery. Neovagina was created with a technique using bilateral pudendal thigh flaps.

Results: Age distribution shows that 19 (95%) patients were between 15- 20 years old. The mean age of the patients was 17.9 (± 3.39) years. The average length and breadth of the designed flap were 11.5 (± 0.089) and 5.1 (± 0.22) cm respectively. During the post-operative follow up 16 (80%) patients presented with neovaginal length ≥ 7 cm. 17 (85%) patients could appreciate touch and pain sensation at their neovagina. In-hospital outcome of the patients demonstrates that only 1 (5%) patients had marginal flap loss (<1 cm). The reconstructed vagina was expansible and post-operative stenting or dilatation was not required.

 Conclusion: Pudendal thigh flap is a useful technique to reconstruct the vagina which can provide satisfactory anatomical and functional outcome with negligible post-operative problems.