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利用组织工程生物材料网片行阴道成形术治疗 Mayer-Rokitansky-Küster-Hauser 综合征患者的临床转归。

The clinical outcomes of vaginoplasty using tissue-engineered biomaterial mesh in patients with Mayer-Rokitansky-Küster-Hauser syndrome.

机构信息

Department of Obstetrics and Gynecology, PLA General Hospital, Beijing, PR China; Department Gynecology and Obstetrics of CAPF General Hospital, 69 Yongding Rd., Beijing 100039, PR China.

Department of Obstetrics and Gynecology, PLA General Hospital, Beijing, PR China; Department of Obstetrics, The General Hospital of Jinan Military Command, Jinan, PR China.

出版信息

Int J Surg. 2017 Aug;44:9-14. doi: 10.1016/j.ijsu.2017.06.026. Epub 2017 Jun 10.

Abstract

OBJECTIVE

The aim of the study is to evaluate the clinical outcomes of vaginoplasty using tissue-engineered biomaterial mesh in the patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome.

PATIENTS AND METHODS

Patients with MRKH syndrome underwent the vaginoplasty using tissue-engineered biomaterial mesh between January 2006 and August 2014 in PLA general hospital. We analyzed the anatomic results and collected the standardized FSFI (Female Sexual Function Index) questionnaire from each patient.

RESULTS

Totally forty patients with MRKH syndrome were enrolled in the present study. The surgical procedures were performed without any major complication except that intraoperative bladder injury occurred in one case and was repaired successfully. The mean duration of surgery was 85.3 min (SD = 8.7), the mean blood loss was 58.7 ml (SD = 36.5). The mean hospital stay after surgery was 8.8 days (SD = 4.7). Three monthes after surgery, superduper mucosa was found in the neovagina of all enrolled patients. Twelve weeks after surgery, a satisfactory vaginal length of at least 9 cm was attained in all patients, and vaginal cross-sectional diameter more than 2 cm. The scar contracture, necrosis or rejection did not occurred in any patient. The anatomic success rate was 100%. All these sexually active patients answered the FSFI questionnaire and completed all the 19 items in the questionnaire. The mean total FSFI score of these patients was 25.2.

CONCLUSIONS

The vaginoplasty using tissue-engineered biomaterial mesh procedure can act as a safe and effective surgical strategy for patients with MRKH syndrome. However, larger scale studies with longer follow-up profiles are needed to justify its widespread utilization.

摘要

目的

本研究旨在评估组织工程生物材料网片在 Mayer-Rokitansky-Küster-Hauser(MRKH)综合征患者阴道成形术中的临床效果。

患者和方法

2006 年 1 月至 2014 年 8 月,解放军总医院对 40 例 MRKH 综合征患者行组织工程生物材料网片阴道成形术。我们分析了解剖学结果,并从每位患者收集了标准化的 FSFI(女性性功能指数)问卷。

结果

本研究共纳入 40 例 MRKH 综合征患者。手术过程中无重大并发症,除 1 例术中发生膀胱损伤并成功修复外。手术平均时间为 85.3 分钟(标准差=8.7),平均出血量为 58.7 毫升(标准差=36.5)。术后平均住院时间为 8.8 天(标准差=4.7)。术后 3 个月,所有入组患者的新阴道均发现超级黏膜。术后 12 周,所有患者均获得至少 9cm 的满意阴道长度,阴道横截面积大于 2cm。无患者发生瘢痕挛缩、坏死或排斥。解剖成功率为 100%。所有有性生活的患者均回答了 FSFI 问卷,并完成了问卷中的 19 个项目。这些患者的平均总 FSFI 得分为 25.2。

结论

组织工程生物材料网片阴道成形术可为 MRKH 综合征患者提供一种安全有效的手术策略。然而,需要更大规模的研究和更长时间的随访来证明其广泛应用的合理性。

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