Department of Critical Care Medicine.
Department of General Surgery, Shengjing Hospital of China Medical University, China.
Medicine (Baltimore). 2021 Mar 5;100(9):e24972. doi: 10.1097/MD.0000000000024972.
Vaginal agenesis is a congenital disorder, which can be managed by nonsurgical dilation or surgical reconstruction of the vagina. The sigmoid vaginoplasty procedure is a popular approach, which pulls down part of the sigmoid colon to form a neovagina. One complication of this procedure is introital stenosis.
A 55-year-old woman presented to the outpatient general surgery department with severe, persistent abdominal pain. The patient was diagnosed with congenital absence of uterus and vagina, and a sigmoid vaginoplasty was performed 34 years ago.
A pelvic MRI and an abdominal enhanced CT scan were performed, finding that the uterus was absent, and the os of the vagina was closed, forming a closed loop full of fluid. Introital atresia and closed loop of neovaginal colon conduit were diagnosed.
Based on our conclusions and the patient's consent we surgically removed the neovagina.
After surgery, the abdominal pain was relieved, and the patient reported full recovery during a 6-month follow-up appointment.
Introital stenosis is one of the long-term complications of sigmoid vaginoplasty procedure. Introital stenosis, leading to introital atresia, is rare but may occur. Surgical removal of neovagina can relieve the pain in patients who do not have the demand of sexual intercourse.
阴道发育不全是一种先天性疾病，可以通过非手术扩张或手术重建阴道来治疗。乙状结肠阴道成形术是一种常用的方法，它将部分乙状结肠向下拉以形成新的阴道。该手术的一个并发症是阴道入口狭窄。
一位 55 岁的女性因严重、持续的腹痛到普通外科门诊就诊。该患者被诊断为先天性子宫和阴道缺失，并在 34 年前进行了乙状结肠阴道成形术。
进行了盆腔 MRI 和腹部增强 CT 扫描，发现子宫缺失，阴道开口关闭，形成一个充满液体的闭环。诊断为阴道入口闭锁和新阴道乙状结肠管环闭。
根据我们的结论和患者的同意，我们进行了手术切除新阴道。
手术后，腹痛缓解，患者在 6 个月的随访中报告完全康复。
阴道入口狭窄是乙状结肠阴道成形术的长期并发症之一。虽然阴道入口闭锁很少见，但可能会发生。对于没有性生活需求的患者，切除新阴道可缓解疼痛。
