Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
Fertil Steril. 2017 Aug;108(2):341-345. doi: 10.1016/j.fertnstert.2017.05.026. Epub 2017 Jun 16.
To assess the outcome of amnion vaginoplasty in cases of vaginal agenesis due to Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome managed at the authors' institution.
Retrospective study.
Tertiary care hospital.
PATIENT(S): Fifty women with MRKH who underwent neovaginoplasty.
INTERVENTION(S): Modified McIndoe's vaginoplasty was done in all the patients, using human amnion graft.
MAIN OUTCOME MEASURE(S): Functional status assessed by Female Sexual Function Index, anatomic status (length and width of neovagina), and epithelialization of vagina.
RESULT(S): Mean (±SD) vaginal length after surgery was 8.2 ± 1 cm. Mean vaginal length at 6-month follow-up in sexually active patients was significantly longer as compared with the patients who were not sexually active after surgery (8.4 ± 1.04 cm vs. 6.6 ± 2.4 cm). Mean Female Sexual Function Index score was 30.8 ± 2.1. Vaginal biopsy showed complete epithelialization of vaginal mucosa.
CONCLUSION(S): In a developing nation like India, McIndoe's method with amnion graft seems to be a promising option owing to its low cost, easy availability, and safety, ease of the procedure not requiring any special instrument, physiologic outcome with respect to epithelialization of the vagina without hair growth, and satisfying functional outcome.
评估作者所在机构治疗的因 Mayer-Rokitansky-Kuster-Hauser (MRKH) 综合征而导致的阴道闭锁患者行羊膜阴道成形术的结局。
回顾性研究。
三级护理医院。
50 名患有 MRKH 并接受阴道成形术的女性。
所有患者均采用改良 McIndoe 阴道成形术，使用人羊膜移植物。
采用女性性功能指数评估功能状态，采用阴道长度和宽度评估解剖状态，采用阴道上皮化评估阴道上皮化。
手术后阴道平均长度为 8.2 ± 1cm。术后 6 个月有性生活的患者阴道平均长度明显长于无性生活的患者（8.4 ± 1.04cm 比 6.6 ± 2.4cm）。平均女性性功能指数评分为 30.8 ± 2.1。阴道活检显示阴道黏膜完全上皮化。
在印度这样的发展中国家，由于 McIndoe 方法联合羊膜移植物具有成本低、易于获取和安全、操作简单无需特殊器械、生理结局为阴道上皮化无毛发生长、以及满意的功能结局等优点，因此似乎是一种很有前途的选择。
