生殖器自残心理因素和急诊外阴成形术的医学伦理学研究(法)

The genital self- mutilation is not rare in women. Risk factors found in these cases are: mood disorders, food behavior anomalies and antecedents of sexual aggression. However, surgical repair is not done in emergency: we find no similar report to our clinical case describing an added up bilateral reduction nymphoplasty carried out in emergency after hemorrhagic genital self-mutilation. We discuss psychological risk factors, psychiatric diagnosis and optimal treatment, studied from medico-ethical point of view, for this surgical emergency.

外阴畸形的诊断及治疗

常见的先天性外阴畸形有处女膜闭锁、女性假两性畸形及腹膜鞘突囊肿。一、处女膜闭锁又称处女膜无孔,是先天性外阴畸形中最常见的一种。新生儿宫颈受母亲雌激素的影响,分泌较多的粘液,粘液积聚于阴道内,可使外阴部膨出。严重者,阴道子宫内积聚的大量分泌液使阴道,子宫膨胀,压迫尿道,引起急性尿潴留。检查时外阴部见不到阴道口,在处女膜所在处明显膨隆,在此处作穿刺,可得多量粘液即可确诊。处女膜无孔的女孩在新生儿期未出现症状者,至青春期无月经来潮,但伴有周期性下腹痛。多次经血积聚后常可在下腹正中扪到逐渐增大的包块,严重者常伴有便秘、尿频或尿潴留等症状。检查时见处女膜无孔或形成透紫膨隆膜。肛查可扪到压向直肠且紧张度大、有触痛的包块。在处女膜膨隆处穿刺,可得陈旧性血液。