腹腔镜下腹膜代阴道成形术的临床观察

Clinical observation on laparoscopic peritoneal vaginoplasty

目的:探讨腹腔镜下腹膜代阴道成形术的临床效果。方法:回顾性分析13例行腹腔镜下腹膜代阴道患者的临床资料,观察手术时间、术中出血、术后患者恢复情况及人工阴道生长情况,应用FSFI量表评估患者性功能。结果:13例患者手术均无并发症发生,手术时间(116.67±27.78)min,术中出血(45.42±7.71)m L,术后肛门排气时间(25.25±9.83)h,术后住院时间(12.92±1.90)d,随访人工阴道内表面均光滑,深约8~10cm,宽度约2~3指,MRKH组在性欲、性唤起、阴道润滑、性满意度、性交痛项目评分及FSFI总分与对照组相比,差异无统计学意义(P>0.05),男性满意度两组比较差异无统计学意义(P>0.05)。结论:腹腔镜下腹膜代阴道成形术是目前治疗先天性无阴道患者的理想的方法,值得临床推广。

Objectives： To investigate the clinical effect of laparoscopic peritoneal vaginoplasty for the treatment of congenital absence of vagina. Methods： The clinical data of 13 patients underwent laparoscopic peritoneal vaginoplasty were retrospectively analyzed. The operation time,blood loss,postoperative course and postoperative function of vagina were observed. The sexual state of these patients were evaluated using FSFI questionnaire.Results： The laparoscopic was successfully completed in all 13 cases,without complication. The operation lasted for116. 67 ± 27. 78 minutes,with blood loss volume of 45. 42 ± 7. 71 ml. The time to passage of gas by anus was 25. 25± 9. 83 h,and the postoperative hospital stay 12. 92 ± 1. 90 d. Artificial vagina mucosa was smooth in the follow up. The length of vagina was 8-10 cm with a width allowing the introduction of 2-3 fingers. Differences in the sexual desire,arousal,lubrication,satisfaction,discomfort and the total FSFI score was not statistically significant between MRKH and control group（ P 0. 05）. There was no statistical significance in the male sexual satisfaction between the two groups（ P 0. 05）. Conclusion： Laparoscopic peritoneal vaginoplasty is a safe,effective treatment for congenital absence of vagina,worth promoting.