Giraldo F, Solano A, Mora M J, Abehsera M, González C, Rus J A
Plastic and Reconstructive Unit, Regional Hospital 'Carlos Haya' Málaga, Spain.
Plast Reconstr Surg. 1996 Aug;98(2):305-12. doi: 10.1097/00006534-199608000-00015.
We report our experience in vaginoplasty for the treatment of six cases of the Mayer-Rokitansky syndrome using bilateral vulvoperineal fasciocutaneous flaps measuring 8 to 9 X 3 cm. We consider a detailed description of the operative technique, noting the modifications that we have introduced as our experience increased, in addition to the cosmetic and functional results. On the other hand, the indications for using this vaginoplasty are presented. On the basis of our clinical results, the actual anatomy of the blood vessels leading to the pedicle of the flap, and the geometric design of the vulvoperineal flap, the following technical points can be made: (1) It is a secure and reliable technique because of well-established vascularization beneath the lateral border of the labia majora. (2) It is a straightforward method because the transposition and rotation of a vertical flap is easier than the use of more distant flaps. (3) There is a minor risk of injury to the superficial perineal neurovascular pedicle and Bartholin's gland. (4) Innervation extends into the external two-thirds of the artificial vagina. And (5) an acceptable cosmetic and functional result is achieved without the need to use dilators, obturators, or molds.
我们报告了使用双侧大小为8至9×3厘米的外阴会阴筋膜皮瓣进行阴道成形术治疗6例迈耶-罗基坦斯基综合征的经验。我们详细描述了手术技术，除了美容和功能结果外，还指出了随着经验增加而引入的改进之处。另一方面，介绍了使用这种阴道成形术的适应症。根据我们的临床结果、导致皮瓣蒂部的血管实际解剖结构以及外阴会阴皮瓣的几何设计，可以得出以下技术要点：（1）由于大阴唇外侧边缘下方有完善的血管化，这是一种安全可靠的技术。（2）这是一种直接的方法，因为垂直皮瓣的移位和旋转比使用更远距离的皮瓣更容易。（3）存在轻微损伤会阴浅神经血管蒂和巴氏腺的风险。（4）神经支配延伸至人工阴道的外三分之二。并且（5）无需使用扩张器、闭孔器或模具即可获得可接受的美容和功能效果。
