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目的探讨先天性无阴道的临床特点及治疗方法。方法回顾性分析2010年6月至2015年6月在我院诊治的26例先天性无阴道患者的临床资料。结果 16例前庭隐窝深度小于3 cm的患者行腹腔镜腹膜代阴道成形术均成功,平均手术时间(76±16)min,中位出血量30 ml。术后1例患者阴道出血给予缝合止血,术后阴道深度8~10cm,1例失访,已有性生活者14例,性生活满意者13例。10例前庭隐窝深度大于3cm的患者行阴道模型顶压法均成功,平均治疗时间(90±10)d,术后阴道深度7~10cm,1例失访,性生活满意者7例。术后两组平均随访3~60个月,两组阴道长度、性生活的满意度差异无统计学意义。结论腹腔镜腹膜代阴道成形术和阴道模型顶压法均为安全有效的方法,对于前庭隐窝深度大于3cm的患者,可首选阴道模型顶压法。
Objective To investigate the clinical characteristics and treatment of congenital absence of vagina. Methods The clinical data of 26 patients with congenital absence of vagina diagnosed and treated in our hospital from June 2010 to June 2015 were retrospectively analyzed. Results In all 16 patients with less than 3 cm depth of vestibular recess, laparoscopic peritoneal vaginoplasty was performed successfully. The average operation time was 76 ± 16 min and the median bleeding volume was 30 ml. Postoperative vaginal bleeding in 1 patient was given suture hemostasis. The postoperative vaginal depth was 8 ~ 10 cm and 1 patient was lost. There were 14 cases of sex life and 13 cases of sexual life satisfaction. In 10 cases with a depth of more than 3 cm in the vestibular recess, the patients underwent vaginal top pressure were successfully treated. The average treatment time was 90 ± 10 days, the postoperative vaginal depth was 7 to 10 cm, and 1 patient was lost to follow-up. The average postoperative two groups were followed up for 3 to 60 months. There was no significant difference in the satisfaction of sex life between the two groups. Conclusions Laparoscopic peritoneal vaginoplasty and vaginal top pressure are safe and effective. For the patients with vestibular recess depth greater than 3 cm, the preferred vaginal top pressure method can be used.