Sánchez Contreras Jesús, Pasos Romero Ignacio, Celio Mancera Jorge, Hernández Vivar Luis Edmundo
Hospital Juárez de México, México, DF.
Ginecol Obstet Mex. 2006 Jan;74(1):37-47.
Vaginal agenesis is a rare congenital disorder. It requires surgical management and still it is not defined universally. The surgical resolution of the pure vaginal agenesis, through fasciocutaneous pudendal thigh flaps, has few complications and allows the copulative function in normal conditions.
To assess the results of the vaginal agenesis surgical management.
From January 1996 to January 2005 we identified 33 patients with Müllerian duct and urogenital sinus disorders; eight of them had vaginal agenesis diagnosis. All the patients were subject to: complete medical history, karyotype study, determination of a complete gynecological profile, pelvic ultrasound, excretory urography, and, in some acute cases of hematometra or hematosalpinx, to an intervention with two surgical equipments: one of them used for the hematic collection emptiness of the internal genitals and the other one to solve the mechanical obstruction of vaginal agenesis. In some cases the study was completed through diagnostic laparoscopy.
In our series six patients had functional uterus. When we made the surgical intervention we tried to make the uterus tunelization in the neovagina through the use of a Foley catheter. Nevertheless, they continued with symptoms of cyclical pelvic pain and chronic hematometra. One of the patients was exposed to total abdominal hysterectomy without bilateral oophorectomy, and in two more we are planning to make the same procedure in a short term.
Fasciocutaneous pudendal thigh flaps technique is easy, safety and reliable, and it allows the creation of a neovagina in only one surgical time.
阴道闭锁是一种罕见的先天性疾病。它需要手术治疗，但其定义尚未统一。通过阴部大腿筋膜皮瓣对单纯阴道闭锁进行手术治疗，并发症较少，且能使患者在正常情况下具备性交功能。
评估阴道闭锁手术治疗的效果。
1996年1月至2005年1月，我们确定了33例苗勒管和泌尿生殖窦疾病患者；其中8例被诊断为阴道闭锁。所有患者均接受了全面的病史采集、染色体核型分析、完整的妇科检查、盆腔超声、排泄性尿路造影，在一些子宫积血或输卵管积血的急性病例中，还使用了两种手术设备进行干预：一种用于清除内生殖器的积血，另一种用于解决阴道闭锁的机械性梗阻。在某些情况下，通过诊断性腹腔镜检查完成了研究。
在我们的系列研究中，6例患者有功能性子宫。在进行手术干预时，我们试图通过使用Foley导管在新阴道内形成子宫隧道。然而，她们仍有周期性盆腔疼痛和慢性子宫积血的症状。其中1例患者接受了全腹子宫切除术，但未进行双侧卵巢切除术，另外2例患者我们计划在短期内进行相同的手术。
阴部大腿筋膜皮瓣技术简便、安全且可靠，仅需一次手术即可创建新阴道。
