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我们在阴道发育不全管理方面的经验:其社会心理影响以及对比磁共振成像扫描结合阴道模具在高位横隔型阴道隔解读中的作用。

Our Experience in the Management of Vaginal Agenesis: Its Psychosocial Impact and Role of Contrast Magnetic Resonance Imaging Scan with Vaginal Mold in the Interpretation of High Transverse Vaginal Septum.

作者信息

Kala Deepa, Naik Narendra G, Agarwal Amit

机构信息

Professor in Obstetrics & Gynecology, Terna Medical College, Nerul, Navi Mumbai, Maharashtra, India.

Associate Professsor in General surgery & Consultant Plastic surgeon, Terna Medical College, Nerul, Navi Mumbai, Maharashtra, India.

出版信息

J Hum Reprod Sci. 2019 Jan-Mar;12(1):67-71. doi: 10.4103/jhrs.JHRS_82_18.

Abstract

BACKGROUND

Mullerian anomalies are of many types, and it is very difficult to classify them in a simple method and plan reconstructive surgery. The aims, objective and the reconstructive surgical approach varies according to the level of vaginal agenesis as seen in our experience of management of 11 cases. The difficulties in the perception and interpretation of the surgical anatomy on magnetic resonance imaging can be minimized by placing a soft vaginal mold inside the lower developed vaginal segment in cases with transverse vaginal septum.

METHODS

Retrospective observational study.

RESULTS

All the operated 10 adult patients showed good created vaginal space which helped in creating good bonding in between the couples to maintain the integrity of marriage. Better successful reconstructive surgical planning by placing a soft vaginal mould in the vagina during MRI scan helps in understanding the level of septum in our single operated case of transverse vaginal septum and given excellent postoperative result.

CONCLUSION

The impact of surgery on family life and sexual profile of the patient postsurgery on long-term has been mentioned on rare occasion. The preoperative counseling of the couples helps in better postoperative outcome in terms of psychological and sexual satisfaction of the partners and in the treatment of primary amenorrhea and infertility.

摘要

背景

苗勒管异常有多种类型,很难用一种简单的方法进行分类并规划重建手术。根据我们对11例患者的治疗经验,手术目的、目标及重建手术方法会因阴道发育不全的程度而有所不同。对于存在阴道横隔的病例,通过在发育较差的阴道下段放置柔软的阴道模具,可将磁共振成像中手术解剖结构感知和解读的困难降至最低。

方法

回顾性观察研究。

结果

所有接受手术的10例成年患者均形成了良好的阴道腔隙,这有助于夫妻间建立良好关系,维持婚姻完整。在磁共振成像扫描时于阴道内放置柔软的阴道模具,能更好地成功规划重建手术,有助于了解我们单一例阴道横隔手术患者的隔膜位置,并取得了出色的术后效果。

结论

手术对患者术后家庭生活和性特征的长期影响鲜有提及。术前对夫妻进行咨询有助于在心理和性满意度方面以及原发性闭经和不孕症治疗方面取得更好的术后效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbe6/6472209/89cf5baa44f7/JHRS-12-67-g001.jpg

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