Department of Obstetrics and Gynecology, Faculty of Medicine, University of Pécs, Pécs, Hungary.
Acta Obstet Gynecol Scand. 2007 Oct;86(10):1231-5. doi: 10.1080/00016340701622674.
Many types of operations are described to create a neovagina in a patient with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, that sometimes result in injury of the surrounding organs. Many trials are detailed in the literature to avoid these complications. Our goal was to examine the benefit of 'endovaginal' sonography during a laparoscopy-assisted Vecchietti operation to avoid bladder injuries.
A neovagina was created in 15 women with MRKH syndrome by the method of Vecchietti assisted by laparoscopy. The method was modified with the use of‘endovaginal' sonography, in order to reduce bladder and rectal injuries. The vaginal ultrasound transducer, placed in front of the vaginal dimple, can guide penetration from the perineum into the peritoneal cavity. With this technique, the narrow space between the bladder and rectum can be well identified.
All operations were successful, without any complication, forming a well-functioning 8-10 cm long neovagina, allowing easy introduction of two fingers in all cases, and with good quality of sexual life for the couples.
Creation of a neovagina by any method in MRKH syndrome may sometimes result in injury of the bladder or rectum due to the narrow space between the bladder and rectum. The placement of the endovaginal ultrasound transducer in front of the vaginal dimple seems to be a promising method to avoid these complications during a laparoscopy-assisted Vecchietti operation.
许多手术类型被描述用于创建 Mayer-Rokitansky-Küster-Hauser（MRKH）综合征患者的新阴道，这些手术有时会导致周围器官损伤。文献中有许多试验详细描述了如何避免这些并发症。我们的目标是检查在腹腔镜辅助 Vecchietti 手术中使用“阴道内”超声来避免膀胱损伤的益处。
通过腹腔镜辅助 Vecchietti 方法在 15 名 MRKH 综合征女性中创建了新阴道。该方法经过改良，使用了“阴道内”超声，以减少膀胱和直肠损伤。将阴道超声换能器放置在阴道凹痕前方，可引导从会阴进入腹腔的穿刺。使用这种技术，可以很好地识别膀胱和直肠之间的狭窄空间。
所有手术均成功完成，无任何并发症，形成了一个功能良好的 8-10 厘米长的新阴道，所有病例均能轻松插入两指，并且夫妻双方的性生活质量良好。
由于膀胱和直肠之间的狭窄空间，MRKH 综合征中任何方法创建新阴道有时都会导致膀胱或直肠损伤。将阴道内超声换能器放置在阴道凹痕前方似乎是一种有前途的方法，可以在腹腔镜辅助 Vecchietti 手术中避免这些并发症。
