Alessandrescu D, Peltecu G C, Buhimschi C S, Buhimschi I A
Department of Obstetrics and Gynecology, Polizu Clinical Hospital, Bucharest, Romania.
Am J Obstet Gynecol. 1996 Jul;175(1):131-8. doi: 10.1016/s0002-9378(96)70262-4.
Our goals were to present a modified Abbe-Mcindoe technique of vaginoplasty with split-thickness skin graft and to analyze 51 years of experience in performing this procedure.
Two hundred one women with vaginal agenesis were diagnosed and operated on by the same surgeon in 51 years (1943 through 1994). The patients' ages ranged from 14 to 41 years with an average of 20.5 years (SD 3.9 years). In most of the cases surgical intervention was performed when the patient desired to begin her sexual experience. The graft was taken from the thigh or gluteal region, followed by dissection of the urethrovesicorectal space. The access in this space was performed through two mutually perpendicular incisions (a modification of the Abbe-Mcindoe technique). A multiholed, rigid plastic mold was inserted during surgery and was replaced after 8 to 10 days with a semirigid silicone mold, which remained in place at least 6 months after operation or until the patient became sexually active.
We retrospectively reviewed 201 cases of Mayer-Rokitansky-Küster-Hauser syndrome in which vaginoplasty was performed. The data were obtained from the personal records of Dan Alessandrescu, MD, PhD, for the 76 cases operated on between 1943 and 1967 and from the medical records in the Polizu Hospital Archive, Bucharest, Romania, for 125 cases operated on between 1968 and 1994. Overall surgical mortality was null. Intraoperative and postoperative complications consisted of two rectal perforations (1%), eight graft infections (4.0%), and 11 infections of graft-site origin (5.5%). Additional information was obtained during follow-up. Sexual satisfaction was investigated with objective (depth of constructed vagina) and subjective (ability to have sexual intercourse, presence or absence of dyspareunia, vaginal lubrication, orgasm) criteria and was analyzed on a qualitative scale. In 12 patients we performed biopsies of the neovaginal wall for histologic evaluation.
Because of the simplicity, low morbidity, and high success rate, our modified Abbe-Mcindoe technique is a procedure of choice for vaginoplasty.
我们的目标是介绍一种改良的采用中厚皮片移植的阴道成形术阿贝 - 麦金杜技术，并分析实施该手术51年的经验。
在51年（1943年至1994年）间，同一位外科医生诊断并为201例阴道发育不全的女性实施了手术。患者年龄在14岁至41岁之间，平均年龄为20.5岁（标准差3.9岁）。在大多数情况下，当患者希望开始性体验时进行手术干预。皮片取自大腿或臀部区域，随后进行尿道膀胱直肠间隙的解剖。该间隙的入路通过两个相互垂直的切口进行（阿贝 - 麦金杜技术的改良）。手术期间插入一个多孔刚性塑料模具，8至10天后用半刚性硅胶模具替换，该模具在术后至少保留6个月或直至患者开始有性生活。
我们回顾性分析了201例接受阴道成形术的迈耶 - 罗基坦斯基 - Küster - 豪泽综合征病例。数据来自丹·亚历山德雷斯库医学博士、哲学博士1943年至1967年间手术的76例患者的个人记录，以及罗马尼亚布加勒斯特波利祖医院档案中1968年至1994年间手术的125例患者的病历。总体手术死亡率为零。术中及术后并发症包括2例直肠穿孔（1%）、8例皮片感染（4.0%）和11例皮片供区感染（5.5%）。随访期间获得了更多信息。通过客观标准（重建阴道的深度）和主观标准（性交能力、有无性交困难、阴道润滑、性高潮）调查性满意度，并进行定性分析。我们对12例患者的新阴道壁进行了活检以进行组织学评估。
由于操作简单、发病率低且成功率高，我们改良的阿贝 - 麦金杜技术是阴道成形术的首选术式。
