部分小阴唇皮瓣网状移植人工阴道成形术治疗先天性阴道闭锁或先天性无阴道9例
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摘要
目的:探讨部分小阴唇皮瓣网状移植人工阴道成形术治疗先天性无阴道或阴道完全闭锁的临床效果及优越性。方法:对2011年5月至2017年9月收治的先天性阴道闭锁合并宫颈闭锁或先天性无阴道病人9例,设计并施行部分小阴唇皮瓣网状移植人工阴道成形术或宫颈成形术,对手术效果进行评估。结果:9例手术均顺利,出院前阴道深度均达到7～9 cm。远期随访:9例病人阴道宽度与深度均满意;5例保留子宫的月经周期正常,术后均无腹痛发生;7例已结婚,婚后性生活均满意。结论:部分小阴唇皮瓣网状移植人工阴道成形术是治疗先天性阴道闭锁或先天性无阴道病人的首选手术方式之一。
Objective:To explore the feasibility and clinical effects of using vaginoplasty partial labia flap mesh graft in the treatment of congenital complete vaginal atresia or congenital absence of vagina.Methods:From May 2011 to September 2017,nine cases with congenital atresia of vagina complicated with congenital abnormal cervix or congenital absence of vagina were treated with vaginoplasty or cervicoplasty using partial labia flap mesh graft,and the operation results were evaluated.Results:All operations were successful,and the depth of vagina arrived at 7 to 9 cm before discharge.Long term follow-up:nine cases were satisfied with the width and depth of the vagina.Five cases rserved uterine had normal menstral cycle,who had no dysmenorrhe.Seven cases were already married with satisfied sex.Conclusions:Cervicovaginal reconstruction with part of the labia minora flap retiform transplantation is an effective alternative for treating congenital complete vaginal atresia combined with cervical atresia or congenital absence of vagina.
Objective:To explore the feasibility and clinical effects of using vaginoplasty partial labia flap mesh graft in the treatment of congenital complete vaginal atresia or congenital absence of vagina.Methods:From May 2011 to September 2017,nine cases with congenital atresia of vagina complicated with congenital abnormal cervix or congenital absence of vagina were treated with vaginoplasty or cervicoplasty using partial labia flap mesh graft,and the operation results were evaluated.Results:All operations were successful,and the depth of vagina arrived at 7 to 9 cm before discharge.Long term follow-up:nine cases were satisfied with the width and depth of the vagina.Five cases rserved uterine had normal menstral cycle,who had no dysmenorrhe.Seven cases were already married with satisfied sex.Conclusions:Cervicovaginal reconstruction with part of the labia minora flap retiform transplantation is an effective alternative for treating congenital complete vaginal atresia combined with cervical atresia or congenital absence of vagina.
引文
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[2] 张晓平,刘永莹,李靓,等.经Retzius间隙Vechietti改良阴道成形术[J].现代妇产科进展,2013,22(2):163.
[3] 李靓,谢志红,张晓平,等.阴股局部皮瓣旋转移植人工阴道及宫颈成形术治疗先天性宫颈不全闭锁合并阴道完全闭锁临床分析[J].实用妇产科杂志,2015,31(2):108.
[4] XIE ZH,ZHANG XP,LIU JD,et al.Clinical characteristics of congenital cervical atresia based on anatomy and ultrasound:a retrospective study of 32 cases[J].Eur J Med Res,2014,19:10.
[5] 谢志红.女性生殖系统发育异常诊断治疗学[M].合肥:安徽科学技术出版社,2013:24.
[6] 谢志红,张晓萍,刘建东,等.先天性宫颈闭锁29例分析[J].现代妇产科进展,2009,18(10):754.
[7] 谢志红.先天性宫颈闭锁分型手术治疗方法[J].实用妇产科杂志,2015,31(2):88.
[8] 曹云霞,巫新春.女性先天性生殖系统畸形病人的心理学研究[J].中国实用妇科与产科杂志,2005,21(8):460.
[9] GRAVES WP.Artificial vagina[J].Surg Clin N Am,1921,1:611.
[10] 袁梅,谢志红.FSFI量表评价部分小阴唇皮瓣网状移植阴道及宫颈成形术后病人的性功能状态[J].现代妇产科进展,2015,24(11):848.