A Complete Vaginal Replacement from a Small Tissue Sample

A tissue-engineered approach to clinical vaginal reconstruction in women in now a realistic possibility, based on our experience in a rabbit model.

Damage and loss of vaginal tissue can occur as a result of congenital abnormalities, cancer, trauma, infection and inflammation. Out of necessity, reconstruction is often performed with non-vaginal substitutes such as segments of large intestine or skin. Ensuing complications can include strictures, infection, hair growth, graft shrinkage, and malignancy.

As reported in Transplantation, we expanded autologous cells from a small vaginal biopsy to construct a functional vagina in a rabbit model. Smooth muscle and endothelial cells were expanded in the laboratory and seeded on a scaffold constructed of biodegradable polymers.

Six months after total vaginal replacement, the scaffolds had degraded as intended and the reconstructed tissue closely resembled native vaginal tissue in its cellular organization, protein expression profiles and physical properties. The replacement vaginas also had excellent strength and elasticity and responded appropriately to tests of function. In addition, the tissue had developed a nerve supply, a requirement for optimal function.

These results suggest that the use of vaginal tissue engineered from a patient’s own cells represents an attractive option for the surgical reconstruction of vaginal tissue in women. This approach would have several advantages, including that only a small biopsy of tissue would be required and that using vaginal cells would be expected to reduce complications that arise from using nonvaginal tissue.

(Tissue engineering a complete vaginal replacement from a small biopsy of autologous tissue. De Filippo RE, Bishop CE, Filho LF, Yoo JJ, Atala A. Transplantation. 2008 Jul 27;86(2):208-14. Erratum in: Transplantation. 2008 Sep 15;86(5): 751.)