Abstract: Objective:To compare the clinical value of the artificial vaginoplasty with pudendal-thigh skin flap transplantation and modified Vechietti vaginoplasty through Retzius gap,and explore the latter puncture path and safety.Methods:Eighteen patients with congenital absence of uterus and vagina were treated with vaginoplasty using pudendal-thigh skin flap transplantation(skin flap transplantation group,9 cases) and modified Vechietti vaginoplasty through Retzius gap(modified group,9 cases).The operation time,blood loss,hospital stay,complications and postoperative effects between two groups were compared.Results:All operations were successful.In skin flap transplantation group,except for 1 case lost following-up,8 cases were followed up for 3 months to 2 years.Mild vulvae shape change and 1 case with artificial vagina secondary infection in skin flap transplantation group were found.The modified group were followed up for 4 months to 2.5 years,no vulvae shape change and complications were found.The appropriate width and depth of vagina,lubricated and elastic mucosa and harmonious sexual life in two groups were confirmed.Compared with the skin flap transplantation group,the shorter operation time,less blood loss and shorter hospital stay were found in modified group,the differences of two groups were statistical significance(PConclusions:The modified Vechietti vaginoplasty through Retzius gap is minimally invasive,simple and safe,which is worth clinical promotion.