Department of Obstetrics & Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Sultan Qaboos Univ Med J. 2021 Feb;21(1):e110-e115. doi: 10.18295/squmj.2021.21.01.015. Epub 2021 Mar 15.
Imperforate hymen (IH) is a common genital tract anomaly in women which usually presents after puberty. However, surgical treatment is often considered controversial in religious or conservative communities for sociocultural reasons. This study therefore aimed to assess the efficacy of a novel reconstructive technique involving the preservation of the annular hymen.
This prospective interventional study was performed between July 2013 and October 2019 at the minimally invasive surgery unit of a tertiary university hospital in Egypt. A total of 36 women presenting with primary amenorrhoea and haematocolpus were diagnosed with postpubertal IH. A circular hymenotomy was performed on each patient using a 10 mm laparoscopy trocar tip and sleeve to form a new annular hymen under general anaesthesia while preserving the annular hymen. The primary outcome measure was the persistence of hymenal patency and integrity at follow-up. The secondary outcome measure included post-operative patient satisfaction and pain relief.
The reported technique was feasible in all cases without intraoperative complications. Patency of the reconstructed annular hymen was confirmed at follow-up in all cases; moreover, no intraoperative complications were reported. There was a significant post-operative improvement in pain scores ( <0.001). Both the patients and their parents/guardians reported a high level of satisfaction with the technique.
This novel technique for the correction of IH involving the reconstruction of an annular hymen was found to be a safe, minimally invasive and effective procedure. This technique should be considered a feasible alternative to a conventional hymenotomy as it allows for the resumption of normal hymenal anatomy without overtreatment.
处女膜闭锁（IH）是一种常见的女性生殖道畸形，通常在青春期后出现。然而，由于社会文化原因，出于宗教或保守社区的考虑，手术治疗常常存在争议。因此，本研究旨在评估一种涉及环形处女膜保留的新型重建技术的疗效。
这是一项前瞻性的干预性研究，于 2013 年 7 月至 2019 年 10 月在埃及一家三级大学医院的微创外科病房进行。共有 36 名因原发性闭经和阴道积血就诊的女性被诊断为青春期后 IH。在全身麻醉下，使用 10 毫米腹腔镜穿刺器尖端和套管对每位患者进行环形处女膜切开术，形成新的环形处女膜，同时保留环形处女膜。主要结局指标是随访时处女膜通畅性和完整性的保持情况。次要结局指标包括术后患者满意度和疼痛缓解情况。
所有患者均顺利完成该技术，无术中并发症。所有患者在随访时均确认重建的环形处女膜通畅；此外，无术中并发症报告。术后疼痛评分显著改善（<0.001）。患者及其父母/监护人对该技术的满意度均很高。
本研究报告的涉及环形处女膜重建的 IH 矫正新技术安全、微创且有效。与传统处女膜切开术相比，该技术可作为一种可行的替代方法，因为它可以在不过度治疗的情况下恢复正常的处女膜解剖结构。
