Michlewitz H
J Reprod Med. 1986 Jan;31(1):63-4.
Four patients presented with linear ulcers (hymenal fissures) that had not responded to conventional local therapy or oral antibiotics. These sexually active women had experienced dyspareunia for 8-24 months. Cultures for venereal agents were negative. One patient had two linear ulcers, and the others had only one; all the ulcers were restricted to the hymenal ring at either the 4 or 8 o'clock position. The lesions usually were obscured when the hymen was collapsed, but they were obvious when the ring was expanded. The lesions varied in length from 0.5 to 2 cm and were very shallow, generally 1 mm deep. The ulcers were linear streaks that could be stretched to 3-4 mm wide. Laser ablation of the lesions to a depth of at least 5 mm resulted in complete resolution of the ulcer in two cases. A third patient had almost complete resolution of the lesion after two laser treatments. The fourth patient failed treatment and refused additional treatment. The underlying nature of this recalcitrant condition may be as much an enigma as that of the anal fissure. Laser treatment seems the best approach at present.
四名患者出现了线性溃疡（处女膜裂伤），这些溃疡对传统局部治疗或口服抗生素均无反应。这些有性活动的女性性交困难已持续8至24个月。性病病原体培养结果为阴性。一名患者有两处线性溃疡，其他患者仅有一处；所有溃疡均局限于处女膜环的4点或8点位。处女膜收缩时病变通常不明显，但处女膜环扩张时则很明显。病变长度从0.5厘米至2厘米不等，非常浅，一般深1毫米。溃疡为线性条纹，可拉伸至3至4毫米宽。对病变进行至少5毫米深度的激光消融，使两例患者的溃疡完全愈合。第三例患者在接受两次激光治疗后病变几乎完全愈合。第四例患者治疗失败并拒绝进一步治疗。这种顽固病症的潜在本质可能与肛裂一样成谜。目前激光治疗似乎是最佳方法。
