Kawasaki Akiko, Itagagi Hiroya, Tsumagari Ayako, Ijiri Hiroko, Yoshikawa Hiroyuki, Sato Toyomi
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Department of Obstetrics and Gynecology, Tsukuba Gakuen Hospital, Tsukuba, Japan.
J Obstet Gynaecol Res. 2020 Mar;46(3):542-546. doi: 10.1111/jog.14180. Epub 2019 Dec 19.
Vaginal creation is the standard treatment for Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Although non-surgical method is recommended as a first-line treatment in the American College of Obstetricians and Gynecologists guidelines for gynecological practice, it is not commonly performed in Japan. At our hospital, vaginal dilation using uterine cervical dilators (Hegar's dilator) is performed for patients with MRKH syndrome. We report four cases successfully treated with vaginal dilation. After the examination, patients were instructed to practice daily self-dilation at home. The initiation size was No. 13 with 10.5-mm diameter. After the vaginal cavity was dilated to a depth of 6 cm, the size of dilators was gradually increased until No. 30 with 25-mm diameter in a tip and 28-mm diameter in a trunk. The duration required to achieve the outcome was 5-22 months. All cases were successfully treated without any severe complication.
阴道再造术是治疗 Mayer-Rokitansky-Küster-Hauser（MRKH）综合征的标准方法。尽管美国妇产科医师学会妇科实践指南推荐非手术方法作为一线治疗，但在日本并不常用。在我们医院，对于 MRKH 综合征患者采用子宫颈扩张器（海格扩张器）进行阴道扩张。我们报告了 4 例经阴道扩张成功治疗的病例。检查后，指导患者在家中每日自行扩张。起始尺寸为直径 10.5 毫米的 13 号。当阴道腔扩张至 6 厘米深时，逐渐增加扩张器尺寸，直至尖端直径 25 毫米、杆部直径 28 毫米的 30 号。达到预期效果所需时间为 5 - 22 个月。所有病例均成功治疗，无任何严重并发症。
