Kapoor Rakesh, Sharma Devender Kumar, Singh Kamal Jeet, Suri Amit, Singh Pratipal, Chaudhary Himanshu, Dubey Deepak, Mandhani Anil
Department of Urology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Urology. 2006 Jun;67(6):1212-5. doi: 10.1016/j.urology.2005.12.037.
To evaluate the long-term results of sigmoid vaginoplasty for Mayer-Rokitansky-Kuster-Hauser syndrome. The social and psychological acceptance of the procedure is also discussed in terms of a developing country scenario.
A total of 14 patients with Mayer-Rokitansky-Kuster-Hauser syndrome were treated at our institute from January 1995 to December 2004. Sigmoid vaginoplasty was performed in all patients. The procedure was performed using a combined abdominoperineal approach. Dissection was done between the urethra and rectum to create a bed for the neovaginal colon conduit. A 10-cm segment of sigmoid colon was raised on its vascular pedicle, delivered through the abdominoperineal tunnel, and fixed to the vaginal pit incision. The patient records were reviewed for surgical technique and postoperative complications. Patients underwent a personal interview to assess the postoperative results, social acceptance of the procedure, and sexual satisfaction.
The mean patient age at surgery was 16.8 years. The patients who underwent sigmoid vaginoplasty had good cosmetic results without the need for routine dilation or the problem of excessive mucus production. The postoperative morbidity was minimal. During a mean follow-up of 4.1 years, no stenosis or colitis was encountered. The subjective satisfaction rate with the surgical outcomes in all the patients was 8.01 on a scale of 0 to 10 (0, very disappointed to 10, satisfied).
Sigmoid vaginoplasty is an effective treatment for patients with vaginal atresia. Timed vaginal reconstruction in these patients allows for a better quality of life and social acceptance. It also enables the patient to lead a near-normal sexual life, with high satisfaction rates.
评估乙状结肠阴道成形术治疗迈耶-罗基坦斯基-库斯特-豪泽综合征的长期效果。并结合发展中国家的情况，探讨该手术在社会和心理层面的可接受性。
1995年1月至2004年12月，我院共治疗了14例迈耶-罗基坦斯基-库斯特-豪泽综合征患者。所有患者均接受乙状结肠阴道成形术。手术采用经腹会阴联合入路。在尿道和直肠之间进行分离，为新阴道结肠管道创建一个床。将一段10厘米长的乙状结肠以其血管蒂提起，通过经腹会阴隧道引出，并固定于阴道窝切口处。回顾患者记录以了解手术技术和术后并发症情况。对患者进行个人访谈，以评估术后效果、手术的社会接受度和性满意度。
手术时患者的平均年龄为16.8岁。接受乙状结肠阴道成形术的患者术后外观效果良好，无需常规扩张，也不存在过多黏液分泌的问题。术后发病率极低。在平均4.1年的随访期间，未出现狭窄或结肠炎。所有患者对手术结果的主观满意度在0至10分的量表上为8.01分（0分表示非常失望，10分表示满意）。
乙状结肠阴道成形术是治疗阴道闭锁患者的有效方法。对这些患者进行适时的阴道重建可提高生活质量并获得社会认可。这也使患者能够过上近乎正常的性生活，满意度较高。
