Liguori G, Trombetta C, Bucci S, Salamè L, Bortul M, Siracusano S, Belgrano E
Department of Urology, University of Trieste, Trieste, Italy.
Urology. 2005 Aug;66(2):293-8; discussion 298. doi: 10.1016/j.urology.2005.03.091.
To describe 3 cases of successful laparoscopically assisted vaginal reconstruction using an ileal segment in patients with complete neovaginal stenosis.
We evaluated 5 male-to-female transsexual patients who required laparoscopic-assisted vaginal replacement for complete neovaginal stenosis after sex reassignment surgery. We performed complete laparoscopic vaginal isolation and mobilization, external configuration of the vagina, and laparoscopic-assisted vaginal anastomosis.
No intraoperative complications occurred, and laparotomy conversion was not necessary. The mean length of the neovagina at the first postoperative visit was 13 cm. At a mean follow-up of 14 months, all patients were sexually active and completely satisfied with the operation.
Our results have confirmed the feasibility of laparoscopic perineal neovagina construction by ileal colpoplasty. The cosmetic, functional, and anatomic results were encouraging. Isolated ileal segments provided excellent tissue for vaginal replacement, resulting in excellent patient satisfaction and relatively low morbidity. Furthermore, we report a modified surgical approach to conventional ileal vaginoplasty according to the Monti channel principle.
描述3例采用回肠段进行腹腔镜辅助阴道重建治疗完全性新阴道狭窄患者的成功案例。
我们评估了5例性别重置手术后因完全性新阴道狭窄而需要腹腔镜辅助阴道置换的男变女变性者患者。我们进行了完全腹腔镜下阴道分离与游离、阴道外部塑形以及腹腔镜辅助阴道吻合术。
术中未发生并发症，无需中转开腹手术。术后首次复诊时新阴道的平均长度为13厘米。平均随访14个月时，所有患者均有性生活且对手术完全满意。
我们的结果证实了通过回肠阴道成形术进行腹腔镜会阴新阴道构建的可行性。其美容、功能和解剖学结果令人鼓舞。游离的回肠段为阴道置换提供了优质组织，带来了极高的患者满意度和相对较低的发病率。此外，我们根据蒙蒂通道原则报告了一种对传统回肠阴道成形术的改良手术方法。
