Miller Rachel J, Breech Lesley L
Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Clin Obstet Gynecol. 2008 Jun;51(2):223-36. doi: 10.1097/GRF.0b013e31816d2181.
Summary of accurate diagnosis and surgical management of vaginal anomalies. Imperforate hymen, transverse septa, and distal vaginal agenesis present similarly with pain and hematocolpos. Likewise, imperforate hymen, transverse septa, distal vaginal agenesis, and Müllerian aplasia may appear similarly on examination. Imaging should be used to better differentiate the anomaly. Although surgical correction is the mainstay of hymenal anomalies, septa, obstructed hemivaginas, and distal vaginal agenesis, first-line therapy for Müllerian aplasia is progressive dilation. Many surgical techniques are also described but no consensus exists as to the best one. Clinicians should be aware of the appropriate evaluation, differential diagnosis, and management options available for vaginal anomalies.
阴道畸形的准确诊断与手术治疗总结。处女膜闭锁、阴道横隔和阴道远端发育不全在临床表现上相似,均有疼痛和阴道积血。同样,处女膜闭锁、阴道横隔、阴道远端发育不全和苗勒管发育不全在检查时可能表现相似。应采用影像学检查以更好地区分这些畸形。虽然手术矫正仍是处女膜畸形、阴道横隔、阴道半段梗阻及阴道远端发育不全的主要治疗方法,但苗勒管发育不全的一线治疗方法是逐步扩张。文中还描述了多种手术技术,但对于最佳手术技术尚无共识。临床医生应了解阴道畸形的适当评估、鉴别诊断及可用的治疗方案。