Faehnle-Schiegg Ivo, Christmann-Schmid Corina
Luzerner Kantonsspital, Frauenklinik, CH 6000 Luzern, Switzerland.
Int J Womens Health. 2021 Jan 13;13:81-86. doi: 10.2147/IJWH.S285474. eCollection 2021.
A neovaginal prolapse is a rare condition. Only a few cases have been reported and described in literature. The surgical management is complex and depends on the initial surgical techniques for the reconstruction of a neovagina applied. We present a case of a stage IV prolapse of a sigmoid vaginal prolapse and a review of surgical procedures in literature.
We describe the case of a 41-year-old woman with a stage IV prolapse of a sigmoid neovagina who presented 20 years after the initial reconstruction due to a botryoid sarcoma of the pelvis in the childhood. The initial surgical repairs with a fixation of the apex of the sigmoid vagina to the sacral promontory with resorbable suture and consecutively in a second procedure with a polypropylene mesh failed. The interdisciplinary approach with the colorectal team which included a significant shortening of the neovagina prior to the mesh fixation led to a stable repair of the prolapse.
Only a few cases of women with a prolapse of a sigmoid neovagina are published. An interdisciplinary approach including a significant shortening of the neovagina and the fixation with a non-absorbable mesh was necessary to achieve a successful repair. The surgical techniques to create a sigmoid neovagina are crucial in order to perform successful later reconstructive surgery if indicated. Our experience in this case is consistent with the findings from our literature review.
乙状结肠阴道脱垂是一种罕见的病症。文献中仅报道和描述了少数病例。手术治疗较为复杂，取决于最初用于重建乙状结肠阴道的手术技术。我们报告一例乙状结肠阴道Ⅳ度脱垂病例，并对文献中的手术方法进行综述。
我们描述了一名41岁女性的病例，她患有乙状结肠新阴道Ⅳ度脱垂，该患者童年时因盆腔葡萄状肉瘤接受初次重建手术，20年后出现脱垂。最初使用可吸收缝线将乙状结肠阴道顶端固定于骶岬进行手术修复，随后在第二次手术中使用聚丙烯网片修复均失败。与结直肠团队采用的多学科方法，包括在网片固定前显著缩短新阴道，最终成功稳定修复了脱垂。
文献中仅发表了少数乙状结肠新阴道脱垂女性的病例。采用多学科方法，包括显著缩短新阴道并使用不可吸收网片进行固定，对于成功修复至关重要。创建乙状结肠新阴道的手术技术对于后续必要时进行成功的重建手术至关重要。我们在该病例中的经验与文献综述结果一致。
