Abstract
INTRODUCTION AND IMPORTANCE: Vaginal agenesis and transverse septa, rare Müllerian anomalies, make surgery challenging. The ideal neovaginoplasty with minimal complications remains uncertain. Hence, we report here an inverted Y-flap neovaginoplasty with an amnion graft for vaginal agenesis. PRESENTATION OF CASE: A 13-year-old girl with cyclic abdominal pain for a year was diagnosed with hematotrachelos, proximal hematocolpos, transverse vaginal septum, and a unicornuate uterus. She underwent Y-flap neovaginoplasty with an amnion graft after hysteroscopy. Discharged on day 5, she had an 8 cm vaginal length with no menstrual obstruction, showing excellent outcomes. CLINICAL DISCUSSION: The inverted Y-flap neovaginoplasty is a technique used in neovaginal reconstruction, which utilizes skin from the surrounding area to create a new vaginal cavity with an epithelial lining, maintaining its length. Neovaginoplasty with amnion grafts is a rewarding surgery, particularly in low-resource nations, because of its high success rate and low rates of postoperative discomfort, infection, and scarring. CONCLUSION: The inverted Y-flap neovaginoplasty with an amnion graft is a viable option for vaginal agenesis, showing success with minimal complications. Further research can refine surgical protocols.