Lesavoy M A
Urol Clin North Am. 1985 May;12(2):369-79.
Vaginal reconstruction can be an uncomplicated and straightforward procedure when attention to detail is maintained. The Abbé-McIndoe procedure of lining the neovaginal canal with split-thickness skin grafts has become standard. The use of the inflatable Heyer-Schulte vaginal stent provides comfort to the patient and ease to the surgeon in maintaining approximation of the skin graft. For large vaginal and perineal defects, myocutaneous flaps such as the gracilis island have been extremely useful for correction of radiation-damaged tissue of the perineum or for the reconstruction of large ablative defects. Minimal morbidity and scarring ensue because the donor site can be closed primarily. With all vaginal reconstruction, a compliant patient is a necessity. The patient must wear a vaginal obturator for a minimum of 3 to 6 months postoperatively and is encouraged to use intercourse as an excellent obturator. In general, vaginal reconstruction can be an extremely gratifying procedure for both the functional and emotional well-being of patients.
如果注重细节，阴道重建可以是一个简单直接的手术。用中厚皮片内衬新阴道管的阿贝 - 麦金杜手术已成为标准术式。使用可充气的海耶 - 舒尔特阴道支架能让患者感到舒适，也便于外科医生维持皮片贴合。对于大的阴道和会阴缺损，诸如股薄肌岛状肌皮瓣等对会阴受辐射损伤组织的修复或大的切除性缺损的重建极为有用。由于供区可直接缝合，术后发病率和瘢痕形成极小。对于所有阴道重建手术而言，配合的患者是必需的。患者术后必须佩戴阴道闭塞器至少3至6个月，并鼓励其将性交作为一种很好的闭塞方式。总体而言，阴道重建对于患者的功能和情感健康来说可以是一个极其令人满意的手术。
