先天性无阴道26例临床分析

Clinical analysis of 26 cases with congenital absence of vagina

目的探讨先天性无阴道的临床特点及治疗方法。方法回顾性分析2010年6月至2015年6月在我院诊治的26例先天性无阴道患者的临床资料。结果 16例前庭隐窝深度小于3 cm的患者行腹腔镜腹膜代阴道成形术均成功,平均手术时间(76±16)min,中位出血量30 ml。术后1例患者阴道出血给予缝合止血,术后阴道深度8~10cm,1例失访,已有性生活者14例,性生活满意者13例。10例前庭隐窝深度大于3cm的患者行阴道模型顶压法均成功,平均治疗时间(90±10)d,术后阴道深度7~10cm,1例失访,性生活满意者7例。术后两组平均随访3~60个月,两组阴道长度、性生活的满意度差异无统计学意义。结论腹腔镜腹膜代阴道成形术和阴道模型顶压法均为安全有效的方法,对于前庭隐窝深度大于3cm的患者,可首选阴道模型顶压法。

Objective To evaluate the characteristics and treatment of patients with congenital absence of vagina. Methods The clinical data of 26 cases with congenital absence of vagina were analyzed retrospectively. Results Sixteen patients with vaginal vestibular fossae depth lower than 3cm received successful laparoscopic vaginal reconstruction using peritoneum. The average operation time was （76±16） min, the average blood loss was 30 ml. One case was treated with suture hemostasis because of the colporrhagia. Postoperative vaginal depth was 8-10cm, 1 patients was lost, 14 cases had sexual life while 13 cases had satisfied sexual life. The another 10 patients with fossae depth deeper than 3cm received vaginal model top pressure method, the procedure were all successful. The average treatment time was （90±10） d. Postoperative vaginal depth was 7-10cm, 1 patient was lost, 7 cases had satisfied sexual life. Clinical follow-up after surgery of this series was 3 to 60 months. The final results showed no significant differences in the length of vagina and sexual life quality. Conclusion Vaginal model top pressure method, and laparoscopie vaginal reconstruction using peritoneum are both safe and effective treatments. Vaginal model top pressure method can be used as the first therapeutic method for patients with fossae depth deeper than 3cm.