Hage J J, Karim R B, Asscheman H, Bloemena E, Cuesta M A
Department of Plastic and Reconstructive Surgery, Academic Hospital, Free University, Amsterdam, The Netherlands.
Plast Reconstr Surg. 1995 Apr;95(5):842-8; discussion 849-50.
We report on unfavorable long-term results after rectosigmoid neocolpopoiesis in 12 patients, as well as on possible prevention and treatment of these results. To prevent neovaginal introitus stenosis, the rectosigmoid mucosa should be sutured to the perineal skin in an exaggerated interdigital fashion. In cases where introitus stenosis has developed, pedicled transposition flaps from perineum or labia or from the gluteal or inguinal plica region have to be used. Similar flaps also may be applied in cases of rectovagina fistulas. Neuromas at the mucosa-perineal junction often are resistant to therapy. So-called diversion colitis may be manifested by mucous discharge, mucosal bleeding, or discomfort. This disorder may be treated successfully by local application of a solution containing short-chain fatty acids. Loperamidehydrochloride (Imodium) administered half an hour before intravaginal penetration may be helpful to weaken or even prevent neovaginal contractions. Because of the possible higher risk of neovaginal adenocarcinoma, long-term follow-up of these patients is indicated.
我们报告了12例直肠乙状结肠新阴道成形术后的不良长期结果，以及这些结果的可能预防和治疗方法。为防止新阴道口狭窄，应采用夸张的指叉状方式将直肠乙状结肠黏膜缝合至会阴皮肤。在已发生阴道口狭窄的病例中，必须使用来自会阴或阴唇或臀沟或腹股沟皱襞区域的带蒂转移皮瓣。类似的皮瓣也可用于直肠阴道瘘的病例。黏膜与会阴交界处的神经瘤通常对治疗有抗性。所谓的改道性结肠炎可能表现为黏液排出、黏膜出血或不适。这种疾病可通过局部应用含短链脂肪酸的溶液成功治疗。在阴道内插入前半小时服用盐酸洛哌丁胺（易蒙停）可能有助于减弱甚至防止新阴道收缩。由于新阴道腺癌的风险可能更高，因此需要对这些患者进行长期随访。
