Department of Obstetrics and Gynecology, Affiliated of Beijing ChaoYang Hospital, Capital University of Medical Science, Beijing, People's Republic of China.
Fertil Steril. 2013 Dec;100(6):1784-7. doi: 10.1016/j.fertnstert.2013.08.046. Epub 2013 Sep 29.
To report successful treatment by laparoscopically assisted biomaterial graft for reconstruction in patients with congenital atresia of the uterine cervix and vagina.
Technique and instrumentations.
University-based tertiary care hospital.
PATIENT(S): An 18-year-old woman with vaginal agenesis and cervical dysgenesis and a 13-year-old woman with vaginal agenesis and cervical agenesis, both patients with a functional uterus.
INTERVENTION(S): Creation of a neovagina by vaginal procedure and laparoscopically assisted biomaterial graft for uterovaginal anastomosis was performed in all patients.
MAIN OUTCOME MEASURE(S): All surgical findings were carefully reviewed to determine the anatomic characteristics of the malformed cervix. Subsequent follow-up was done by referring physicians.
RESULT(S): Uterovaginal continuity was established successfully in both patients, and all of the women were menstruating normally. Granulomatous polyps occurred in one patient, and this condition was successfully managed. At 6-month follow-up, mean vaginal length was 12 cm and ≥ 80% of neovaginal epithelium was iodine positive in both patients. Unimpeded menstrual flow continued after 4 years of follow-up in one patient and 5 years of follow-up in the other patient.
CONCLUSION(S): A combined laparoscopic and vaginal procedure with biomaterial graft could be an effective alternative in selected women with atresia of cervix and vagina.
报道腹腔镜辅助生物材料移植重建先天性宫颈和阴道闭锁的成功治疗。
技术和仪器。
大学附属三级保健医院。
一名 18 岁的阴道发育不全和宫颈发育不良患者，一名 13 岁的阴道发育不全和宫颈发育不全患者，均为功能性子宫患者。
所有患者均采用阴道手术和腹腔镜辅助生物材料移植进行新阴道的建立和子宫阴道吻合术。
仔细检查所有手术结果，以确定畸形宫颈的解剖特征。后续随访由主治医生进行。
两名患者均成功建立了子宫阴道连续性，所有患者均正常月经来潮。一名患者发生肉芽肿性息肉，该情况得到成功治疗。在 6 个月的随访中，两名患者的阴道平均长度为 12 厘米，80%以上的新阴道上皮碘染色阳性。一名患者在随访 4 年后，另一名患者在随访 5 年后继续保持月经通畅。
对于宫颈和阴道闭锁的特定女性患者，腹腔镜联合阴道手术和生物材料移植可能是一种有效的替代方法。
