基于盆底肌加强的阴道紧缩术

Vaginal Tightening Based on Pelvic Floor Muscle Enhancement

目的探讨通过加强盆底相关肌群在提升阴道紧缩术临床效果中的作用及其关键操作。方法:从作者手术项目组2018年1月至2019年12月期间实施的盆底肌加强型阴道紧缩术案例中,随机选择50例作为观察对象。均采用阴道粘膜和会阴皮肤菱形切口,行粘膜下潜行分离,依次暴露会阴浅横肌、球海绵体肌和双侧肛提肌;首先拉拢缝合固定肛提肌;然后重叠缝合球海绵体肌和会阴浅横肌;最后常规关闭切口。统计手术时间,观察阴道收紧、会阴体高度、盆底肌评估得分及并发症等情况,随访求美者手术满意度。结果:50例阴道紧缩术平均手术时间1.5h;阴道腔中下段均明显缩窄,即刻有效率100%;会阴体高度平均抬高1.9cm。术后2月恢复良好,盆底肌评估得分平均增加33分。术后1例出现缝合口渗血,2例短暂排尿困难,无直肠损伤、血肿、感染等。45例得到完整随访,术后3月、6月、1年求美者性生活平均满意度分别为73%、90%、95%。结论:在阴道紧缩术中重点加强肛提肌、球海绵体肌和会阴浅横肌等盆底肌群,可有效收紧阴道,抬高会阴体,有利于改善阴道握持力,提高性生活满意度,值得临床推广应用。

Objective To explore the role of strengthening pelvic floor related muscle group in improving the clinical effect of vaginal tightening and its key procedures.Methods From January 2018 to December 2019,50 cases of pelvic floor muscle intensive vaginal tightening operated by this surgical team were randomly selected as study subjects.Through rhombic incision of the vaginal mucosa and perineal skin,the bilateral levator ani muscle was exposed by submucosal dissection,the superficial transverse perineum,cavernous globular muscle and bilateral levator ani muscle were exposed in turn.First,close and suture the levator ani muscle,then overlap the cavernous body muscle and superficial transverse perineum muscle,and finally close the incision.The operation time was counted,the vaginal tightening,the height of perineum,the evaluation score of pelvic floor muscle and the complications were observed.The satisfaction of the beauty seekers with the operation was followed up.Results The average operation time of 50 cases of vaginal contraction was 1.5h.The middle and lower segments of the vaginal cavity were significantly narrowed,and the immediate effective rate was 100%.Average height of perineum raised 1.9 cm.After 2 months,the pelvic floor muscle evaluation score increased by 33 points.There were 1 case of bleeding through suture,2 cases of transient dysuria,no rectal injury,hematoma,infection,etc.45 patients received complete follow-up.The average sexual satisfaction was 73%,90%and 95%in 3 months,6 months and 1 year.Conclusion In vaginal tightening,pelvic floor muscle groups such as levator ani muscle,spherical cavernosum muscle and superficial transverse perineum muscle can effectively tighten vagina and raise perineum body,which is beneficial to improve vaginal grip strength and sexual satisfaction,and is worthy of clinical application.