Li Yilin, Liu Meichen, Zhou Yu, Cao Yujiao, Li Fengyong
Urogenital Reconstructive & Gender-affirming Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Surg. 2025 May 9;12:1571769. doi: 10.3389/fsurg.2025.1571769. eCollection 2025.
To evaluate the clinical efficacy of the five-flap technique in the reconstruction of posterior fourchette flap deformities.
A retrospective analysis was conducted on 36 patients with posterior fourchette flap deformities who underwent surgery using the five-flap technique. Preoperative and postoperative pain scores, sexual function scores, and vulvar aesthetic scores were recorded. Additionally, the degree of sexual function improvement and the incidence of complications were assessed. Depending on the distribution of the data, paired -tests or non-parametric tests were employed to compare preoperative and postoperative scores. Descriptive statistics summarized the distribution of sexual function improvements and complications.
The study demonstrated a significant reduction in postoperative pain scores [preoperative: 1.5 [0, 2] vs. postoperative: 0 [0, 1], = 0.001]. Sexual function scores improved from 19.939 ± 3.903 to 28.742 ± 2.766 ( = 0.019), while aesthetic scores increased from 10.50 (9, 12.75) to 21.72 (20.25, 23) ( < 0.001). Based on the definition of sexual function improvement (significant improvement, moderate improvement, no improvement), 72.2% of patients experienced significant improvement, 25.0% moderate improvement, and only 2.8% showed no improvement. Furthermore, no cases of flap necrosis or recurrence were observed. The complication rate was low, with only one case (2.8%) of mild infection and two cases (5.6%) of scar tension, all of which resolved well with local treatment.
The five-flap technique is a safe and effective innovative reconstructive method that demonstrates significant pain relief, sexual function improvement, and aesthetic enhancement in the treatment of posterior fourchette flap deformities. With a low complication rate, it provides a personalized treatment option for complex vulvar deformities.
评估五瓣技术修复后阴唇系带皮瓣畸形的临床疗效。
对36例行五瓣技术手术的后阴唇系带皮瓣畸形患者进行回顾性分析。记录术前和术后的疼痛评分、性功能评分及外阴美观评分。此外，评估性功能改善程度及并发症发生率。根据数据分布情况，采用配对t检验或非参数检验比较术前和术后评分。描述性统计总结性功能改善情况及并发症分布。
研究表明术后疼痛评分显著降低[术前：1.5[0,2]，术后：0[0,1]，P = 0.001]。性功能评分从19.939±3.903提高到28.742±2.766（P = 0.019），而美观评分从10.50（9,12.75）提高到21.72（20.25,23）（P<0.001）。根据性功能改善的定义（显著改善、中度改善、无改善），72.2%的患者有显著改善，25.0%为中度改善，仅2.8%无改善。此外，未观察到皮瓣坏死或复发病例。并发症发生率低，仅1例（2.8%）轻度感染，2例（5.6%）瘢痕张力，经局部治疗均恢复良好。
五瓣技术是一种安全有效的创新性修复方法，在治疗后阴唇系带皮瓣畸形方面能显著缓解疼痛、改善性功能并提升美观度。并发症发生率低，为复杂外阴畸形提供了个性化治疗选择。
