Department of Obstetrics and Gynecology, Okayama University Hospital, Okayama, Japan.
Department of Obstetrics and Gynecology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
J Obstet Gynaecol Res. 2021 Nov;47(11):4122-4126. doi: 10.1111/jog.15005. Epub 2021 Sep 5.
Hematopoietic stem cell transplantation (HSCT) is a crucial treatment for hematological malignancy. Gonadal dysfunction occurs at an early stage after this treatment, and such patients may require hormone replacement therapy. Genital chronic graft-versus-host disease is a lesser-known complication of HSCT that begins with vulvar discomfort and dysuria and progresses to sexual dysfunction and retention of menstrual blood due to vaginal stenosis and obstruction; thus, significantly impairing the patient's quality of life. We describe three women who underwent vaginal reconstruction because of genital chronic graft-versus-host disease. We discuss the surgical techniques, including double cross plasty that were performed in each case. Surgical interventions enabled the continuation of HRT and facilitated sexual intercourse. In conclusion, gynecologists should be aware that genital chronic graft-versus-host disease can occur after HSCT, and that surgical treatment options are available to improve patients' symptoms and quality of life.
造血干细胞移植（HSCT）是治疗血液系统恶性肿瘤的重要手段。这种治疗方法会导致患者在早期出现性腺功能障碍，可能需要激素替代治疗。生殖器慢性移植物抗宿主病是 HSCT 的一种较不为人知的并发症，它始于外阴不适和尿痛，进而发展为性功能障碍，并因阴道狭窄和阻塞而导致月经血潴留，从而严重影响患者的生活质量。我们描述了 3 名因生殖器慢性移植物抗宿主病而接受阴道重建的女性。我们讨论了在每种情况下进行的手术技术，包括双交叉成形术。手术干预使 HRT 得以继续，并促进了性生活。总之，妇科医生应该意识到，生殖器慢性移植物抗宿主病可能会在 HSCT 后发生，并且有手术治疗选择可以改善患者的症状和生活质量。
