Pitfalls in diagnosis and management of distal vaginal agenesis: 10-year experience at a single centre
Pitfalls in diagnosis and management of distal vaginal agenesis: 10-year experience at a single centre
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DOI：
10.1016/j.ejogrb.2012.03.024
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发表时间：
2012-07-01
影响因子：
2.6
通讯作者：
Dikensoy, E.
中科院分区：
文献类型：
--
作者：
Ugur, M. G.;Balat, O.;Dikensoy, E.
目的：讨论远端阴道发育不全的诊断和治疗中的常见陷阱，并总结 11 名患者使用插入式全层移植物和纤维蛋白胶的 10 年经验。研究设计：对 11 名远端阴道发育不全患者进行评估和治疗，采用插入式全层移植物来弥合上阴道和阴道口之间的间隙。相关的肾脏异常和并发症包括感染、完全缺乏植皮、压力性尿失禁、部分移植物丢失、阴道狭窄和移植物摄取均进行了调查。结果：患者的平均年龄为12.91（标准差1.22）岁。所有患者均有原发性闭经、隐经和周期性或持续性盆腔疼痛。没有患者出现相关的泌尿系统异常，也没有感染、完全没有植皮、压力性尿失禁、部分移植物丢失或阴道狭窄的病例。 11 名患者中有 10 名的移植物摄取率为 100%。四名患者随后结婚并报告了满意的性生活。结论：远端阴道发育不全的准确诊断和仔细的术前设置，包括相关异常的评估、肠道准备、可用的阴道支架和针对潜在移植需求的多学科方法，可能是成功的关键。 (c) 2012 Elsevier Ireland Ltd. 保留所有权利。
Objective: To discuss common pitfalls in diagnosis and management of distal vaginal agenesis, and summarize 10 years of experience among 11 patients using an interposition full-thickness graft and fibrin glue.Study design: Eleven patients with distal vaginal agenesis were evaluated and managed with an interposition full-thickness graft to bridge the gap between the upper vagina and the introitus. Associated renal abnormalities and complications including infection, total lack of skin graft take, stress urinary incontinence, partial graft loss, vaginal stricture and graft uptake were all investigated.Results: The mean age of the patients was 12.91 (standard deviation 1.22) years. All patients had primary amenorrhoea, cryptomenorrhea, and cyclical or constant pelvic pain. None of the patients had associated urological abnormalities, and there were no cases of infection, total lack of skin graft take, stress urinary incontinence, partial graft loss or vaginal stricture. Graft uptake was 100% in 10 of the 11 patients. Four patients have subsequently married and report a satisfactory sex life.Conclusion: Accurate diagnosis of distal vaginal agenesis and careful pre-operative set-up, including evaluation of associated anomalies, bowel preparation, available vaginal stents and a multidisciplinary approach for the potential need for grafts, may be key to success. (c) 2012 Elsevier Ireland Ltd. All rights reserved.