Jasonni Valerio M, La Marca Antonio, Naldi Silvia, Matonti Giuseppe, D'Anna Rosario
Mother-Infant Department, Institute of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Modena, Italy.
Fertil Steril. 2007 Dec;88(6):1653-6. doi: 10.1016/j.fertnstert.2007.01.126. Epub 2007 May 3.
To present the results obtained in 104 cases of vaginal aplasia resolved with self-dilatation or with surgical procedures such as the McIndoe or Williams operations.
Retrospective study.
Departments of obstetrics and gynecology of universities in Bologna, Modena, and Messina, Italy.
PATIENT(S): One hundred four cases of vaginal aplasia.
INTERVENTION(S): Self-dilatation and surgical procedures such as the McIndoe or Williams operations.
MAIN OUTCOME MEASURE(S): Outcome of the treatment.
RESULT(S): From 1977 to 2002, 104 cases of vaginal agenesis were treated. The mean age of the treated patients was 16.5 years old (range, 13-18 years). After 6 months of self-dilatation, 41 subjects obtained a new cavity of about 10-12 cm in length. In 14 patients, a space ranging from 3 to 5 cm was obtained. The technique failed in 49 patients. Fourteen patients underwent the Williams surgical procedure, while the remaining 49 patients underwent to the McIndoe procedure. All patients were successfully treated, and the only complication, a rectovaginal fistula that was repaired, occurred in one case of the McIndoe operation.
CONCLUSION(S): Self-dilatation should be the first approach because of its high success rate; the Williams surgical approach should be chosen when self-dilatation partially fails or when previous surgical attempts are unsuccessful. Finally, the McIndoe procedure and its variants should be used when self-dilatation completely fails.
介绍104例通过自我扩张或采用诸如麦金杜（McIndoe）手术或威廉姆斯（Williams）手术等外科手术治疗阴道发育不全的结果。
回顾性研究。
意大利博洛尼亚、摩德纳和墨西拿大学的妇产科。
104例阴道发育不全患者。
自我扩张以及诸如麦金杜手术或威廉姆斯手术等外科手术。
治疗结果。
1977年至2002年期间，共治疗了104例阴道发育不全患者。接受治疗患者的平均年龄为16.5岁（范围为13至18岁）。自我扩张6个月后，41名患者形成了一个长度约为10 - 12厘米的新腔隙。14名患者形成了一个3至5厘米的腔隙。该技术在49名患者中失败。14名患者接受了威廉姆斯手术，其余49名患者接受了麦金杜手术。所有患者均成功治愈，唯一的并发症是麦金杜手术的1例患者出现了直肠阴道瘘，已修复。
由于自我扩张成功率高，应作为首选方法；当自我扩张部分失败或先前手术尝试不成功时，应选择威廉姆斯手术方法。最后，当自我扩张完全失败时，应使用麦金杜手术及其变体。
