Wesley J R, Coran A G
Section of Pediatric Surgery, Mott Children's Hospital, University of Michigan Medical School, Ann Arbor 48109-0245.
J Pediatr Surg. 1992 Jul;27(7):885-9. doi: 10.1016/0022-3468(92)90392-k.
Congenital absence of the vagina is rare and occurs as a result of aplasia of the Müllerian ducts (46,XX) or complete androgen insensitivity syndrome (AIS--46,XY). Both syndromes are associated with normal female external genitalia and these patients are raised as females. These children are usually treated during adolescence with chronic dilatation of the shallow vaginal introitus (pressure tube technique) or by skin graft vaginoplasty (McIndoe procedure). Neither of these procedures is entirely satisfactory, as both may lead to neovaginal stenosis, inadequate length, poor lubrication, or all three. We have recently modified the operation first described by Baldwin in which a loop of sigmoid colon or small bowel is isolated, closed at one end, and brought down on its vascular pedicle as a neovagina and anastomosed to the hymenal ring. We have performed this operation on four adolescents (mean age, 15 years) and two infants (aged 4 days and 14 months) with excellent results (mean follow-up, 7.5 years for the adolescents and 1.8 years for the infants).(ABSTRACT TRUNCATED AT 250 WORDS)
先天性阴道缺失较为罕见，是由苗勒管发育不全（46,XX）或完全雄激素不敏感综合征（AIS - 46,XY）导致的。这两种综合征都伴有正常的女性外生殖器，这些患者按女性抚养。这些患儿通常在青春期接受治疗，采用浅阴道开口慢性扩张术（压力管技术）或皮肤移植阴道成形术（麦金杜手术）。这两种手术都不尽人意，因为它们都可能导致新阴道狭窄、长度不足、润滑不良，或三者皆有。我们最近改良了鲍德温最初描述的手术，即分离一段乙状结肠或小肠，一端闭合，然后将其带血管蒂下移作为新阴道，并与处女膜环吻合。我们已对4名青少年（平均年龄15岁）和2名婴儿（分别为4天和14个月大）实施了该手术，效果极佳（青少年平均随访7.5年，婴儿平均随访1.8年）。（摘要截选至250字）
