双环法阴道紧缩术

目的 介绍一种简单有效的阴道紧缩手术方法。方法 应用3—0丝线或可吸收线，对自觉阴道松弛的患者行黏膜下肌层内连续缝合，环状收缩打结，使阴道黏膜及肌层皱缩隆起，缩小阴道内腔。结果本组患者手术时间20～30min，平均25min。术中无明显出血、手术感染及直肠瘘的发生。术后阴道内无瘢痕。阴道后壁形成数条不规则皱襞。术后随访6个月，性生活较术前满意率达90．9％（10／11）。结论 双环法阴道紧缩术不损伤阴道黏膜，阴道内不遗留瘢痕，损伤小，并发症少，是改善阴道松弛患者性生活质量较为简单有效的方法。     

双侧侧壁埋线隆突法行阴道紧缩术

目的：介绍一种创伤小但有效的阴道紧缩手术方法。方法：采用双侧阴道侧壁粘膜下肌层内间断缝合三针,使阴道粘膜及肌层收紧并向阴道内形成隆突,缩小阴道内腔容积,加阴道口修补。结果：2005年～2011年手术15例,几乎无出血,无感染,无阴道及直肠损伤等并发症,无手术瘢痕,患者均满意。结论：双侧侧壁埋线隆突法行阴道紧缩术是改善阴道松弛的一种简单有效的方法。     

双菱形缝线法阴道紧缩术

目的介绍一种即微创又有效的阴道紧缩手术。方法采用打孔器在会阴处打6个小孔,将2根双向倒齿线经小孔对盆底肌肉行双菱形法缝合,收紧盆底肌肉,缩小阴道口。结果本组20例患者手术时间为30~40 min,平均35 min。出血量较少,无瘢痕形成。获随访6个月,性生活满意度较术前有所提高。结论采用双菱形缝线法阴道紧缩术,设计科学,损伤小,不遗留瘢痕,且并发症较少,是改善阴道松弛及提高患者性生活质量的简单而有效的手术方法。     

球海绵体肌瓣法矫治阴道松弛症探讨

目的:为寻找一种实用有效的治疗产后阴道松弛症的手术方法和临床效果。方法:采用自体阴道分离出撕裂的球海绵体,形成肌瓣。将肌瓣折叠缝合,纵形缝合阴道黏膜,使形成隆突,保留阴道黏膜,加固阴道后壁紧缩阴道腔的手术治疗方法。结果:本组30例患者创口均I期愈合,术后随访6个月至2年,性生活质量均有明显提高,效果较满意。结论:用自体阴道球海绵体肌瓣重叠法治疗阴道松弛症,能明显提高患者性生活质量,效果确切,方法简单,是一种治疗产后阴道松弛症简单有效的方法。     

改良阴道后壁修补术与环肌紧缩术治疗重度阴道松弛的临床比较

目的:比较改良阴道后壁修补术和阴道后壁环肌紧缩术治疗重度阴道松弛的临床疗效。方法:将符合标准的79例重度阴道松弛患者随机分成观察组(41例)和对照组(38例),观察组患者给予改良阴道后壁修补术,对照组患者给予阴道后壁环肌紧缩术。分析观察两组患者手术时间、术中出血量、切口长度、术后伤口愈合情况及并发症,术后1年后评价两组患者的性生活满意度及阴道的松紧度。结果:两种术式的手术时间、术中出血量和切口长度无明显差异(P>0.05),且两组患者均Ⅰ期愈合,无切口感染、直肠或尿道损伤等并发症发生;但术后1年后的远期效果包括性生活满意度和阴道的松紧度有明显差异,观察组优于对照组(P<0.05)。结论:对于重度阴道松弛患者,阴道后壁改良修补术更有利于阴道解剖及功能的全面恢复。     

脱细胞异体真皮在阴道紧缩术及会阴体加固中的应用效果研究

目的:探讨使用脱细胞异体真皮贯穿缝合行阴道缩窄术,并加固会阴体的疗效。方法:首先在阴道侧壁行环形缩窄侧壁肌肉,然后在阴道外1/3段的黏膜下肌层,用脱细胞异体真皮行双半环形缝合收紧后壁肌层,同时在会阴体部用脱细胞异体真皮进行皮下肌肉组织“8”字缝合,并使阴道壁黏膜皱襞嵴性隆起增加。结果:术后阴道壁黏膜皱襞嵴性隆起增加,缩小了管腔直径,会阴体加固。对20例阴道松弛者进行矫治,随访6个月~1年,满意度高。结论:该方法保留了阴道的弹性,不损伤阴道黏膜,阴道内不遗留瘢痕,损伤小,并发症少,更符合生理特性,提高性生活质量,效果确切。     

两种阴道缩窄术矫正阴道松弛症的疗效分析

目的探讨改良阴道后壁修补术和阴道后壁环肌紧缩术的手术要点和效果,评价两种手术的优点及适应证。方法将42例不同程度阴道松弛的患者分为两组,其中24例行改良阴道后壁修补术,18例行阴道后壁环肌紧缩术,分析观察两组患者手术时间、术中出血量、术后伤口愈合情况,1年后评价两组患者的性生活满意度及阴道的松紧度。结果两种手术方法的手术时间、术中出血量及术后伤口愈合情况无明显差异,但1年后的远期效果包括性生活满意度和阴道的松紧度有明显差异。结论矫正阴道松弛症的目的不仅要达到解剖的恢复,更重要的是恢复功能。要根据患者的实际情况选择最佳的手术方法(A组优于B组)。     

两种阴道缩窄术矫正阴道松弛症的疗效分析

目的探讨改良阴道后壁修补术和阴道后壁环肌紧缩术的手术要点和效果,评价两种手术的优点及适应证.方法将42例不同程度阴道松弛的患者分为两组,其中24例行改良阴道后壁修补术,18例行阴道后壁环肌紧缩术,分析观察两组患者手术时间、术中出血量、术后伤口愈合情况,1年后评价两组患者的性生活满意度及阴道的松紧度.结果两种手术方法的手术时间、术中出血量及术后伤口愈合情况无明显差异,但1年后的远期效果包括性生活满意度和阴道的松紧度有明显差异.结论矫正阴道松弛症的目的不仅要达到解剖的恢复,更重要的是恢复功能.要根据患者的实际情况选择最佳的手术方法(A组优于B组).     

保留阴道黏膜阴道紧缩术对阴道松弛患者性生活质量的影响

目的探讨保留阴道黏膜阴道紧缩术的临床应用价值。方法回顾性分析2018-05—2020-04间在新郑市人民医院美容科接受保留阴道黏膜阴道紧缩术治疗的阴道松弛患者的资料,观察手术前后阴道的松弛度、并发症。并对性生活质量进行评价。结果本研究共纳入72例患者,切口均一期愈合,未发生血肿、阴道直肠瘘并发症。术后恢复性生活时发生阴道口感染2例(2.78%),均经对症处理和禁止性生活1个月后愈合。术后6个月时的阴道松弛度评分(4.62±1.12)分、性生活质量评分(20.21±1.92)分,分别高于术前的(1.76±0.54)分、(12.37±1.69)分,差异有统计学意义(P<0.05)。结论对阴道松弛患者实施保留阴道黏膜的阴道紧缩术,并发症少、疗效确切,利于改善阴道松弛状态和提升性生活质量。     

改良的阴道紧缩术治疗阴道松弛临床观察

目的探讨更安全有效的治疗阴道松弛的阴道紧缩手术方法。方法对132例因阴道松弛导致性生活质量下降,要求行阴道紧缩手术的患者进行改良的阴道缩紧术。手术对松弛的阴道前壁和后壁的肌肉及筋膜进行切实有效修复,同时修复会阴裂伤。对合并张力性尿失禁的患者,根据尿道中断吊床学说理论,在修复前壁时于尿道中段加强缝合肌肉筋膜1针;对合并便秘患者,在后壁修复时加强缝合肛提肌3针;前后壁修复时最大限度保护阴道黏膜。结果术后2～7年,随访118例对术后改善性生活满意度、张力性尿失禁、便秘及阴道排气4项内容进行问卷调查,收到满意的临床效果。结论手术方法设计专业,疗效确切,患者满意度高,适合有经验的专科医师采用。     

Small bowel trans-vaginal evisceration following vault biopsy: general surgeons beware!

A case-report of vaginal evisceration following vault biopsy is described. This case highlights the importance of good surgical technique when performing a vaginal biopsy in order to avoid this rare, but life-threatening, complication. General surgeons may well be faced with this acute presentation and prompt management is vital in order to preserve the involved small bowel.     

Vaginal delivery following vaginal inlay grafting

We report the case of a 30-year-old woman with acquired vaginal stenosis secondary to relapsing vaginitis, who became pregnant after partial split-thickness skin graft vaginoplasty. She had a normal pregnancy except for two episodes of vaginitis caused byH. influenzae, which is an uncommon infection during pregnancy, and a normal vaginal delivery. To our knowledge there is only one additional report of vaginal delivery following this kind of surgery. Nevertheless, these isolated cases probably do not demonstrate the suitability of a totally reconstructed vagina by split skin serving as a potentially expansile conduit for normal delivery.     

Vaginal vault suspension and enterocele repair by Richardson-Saye laparoscopic technique: description of training technique and results.

OBJECTIVES: To describe the Richardson-Saye technique for laparoscopic vaginal vault suspension and enterocele repair (vaginal apex reconstruction) and the appropriate training needed for performance of this technique. METHODS: Before using this technique, Drs Carter, Winter, and Mendelsohn first received training by observation of skilled surgeons performing the procedure, attending courses, and finally being tutored and proctored by Dr Saye on the appropriate performance of the technique. They then used this technique to surgically treat eight patients, 42 to 85 years of age, mean age 62 years, between March and September of 1999. RESULTS: We included eight patients in this study who underwent the Saye-Richardson vaginal vault suspension and enterocele repair (apical vaginal vault reconstruction) by the suture technique. In all patients at six-month follow-up, the vaginal apex remains intact and well supported. We describe here the entire vaginal vault suspension and enterocele repair procedure with all its relevant details. CONCLUSION: Laparoscopic reconstruction of the disrupted vaginal apex followed by reattachment to the previously broken uterosacral ligament with the use of permanent suture provides a secure and anatomically correct vault suspension. Before performing this technique, physicians should undergo proper training, including observation, courses, tutoring, and proctorship by a surgeon experienced in performing this technique.     

Rectus fascia colpopexy in posthysterectomy vaginal prolapse: Analysis of 18 cases

Posthysterectomy prolapse of the vaginal vault is a complicated and uncommon occurrence in gynecology. The treatment is surgical and may be either vaginal or abdominal. The great variety of techniques described indicates that there is disagreement about the ideal route or technique to be used. The authors present their experience in surgical correction using colpopexy with rectus abdominal muscle fascia.Editorial Comment: This surgical procedure was originally described by Te Linde in 1962 and later modified by Alves de Lima and Valente. The value of this study is in the relatively long follow-up of 3 years. The authors document minimal complications and good results. It is actually surprising that they did not see postprocedure enteroceles owing to the markedly anterior placement of the vaginal axis.     

球海绵体肌瓣重叠法阴道缩窄术治疗产后阴道松弛

目的：探讨一种有效的阴道缩窄整形术的方法。方法：经阴道口皮肤黏膜交界处切开．剥离阴道黏膜，分离出撕裂的球海绵体肌．形成肌瓣。将肌瓣折叠缝合，然后纵行缝合阴道黏膜，并形成阴道黏膜隆突。结果：本组11例患者均采用球海绵体肌重叠缝合法行阴道缩窄术，9例患者术后随访3个月至2年，夫妻性生活的质量均有明显提高，效果满意。结论：经此手术后可以矫正阴道松弛，提高患者性生活质量，效果确切。     

Vaginal calculi secondary to urethrovaginal fistula with vaginal stenosis in a 14-year-old girl

The author reports a case of vaginal calculi secondary to urethrovaginal fistula with vaginal stenosis in a 14-year-old girl. The initial urethrovaginal fistula and vaginal stenosis resulted from pelvic trauma after a traffic accident, with subsequent surgical urethral realignment and anterior colporrhaphy without success. The patient had continuous urinary incontinence for a duration of 11 years after surgery, and was finally diagnosed with urethrovaginal fistula with primary multiple vaginal calculi in our hospital. Surgeries were performed to remove the stones and repair the urethrovaginal fistula. Colpoplasty was also given by an obstetrician–gynecologist to solve the vaginal stenosis. After the procedure, the girl urinated normally. At her 3-month follow-up, the patient had no sign of urine leakage.     

Neo-vaginal construction with subcutaneously based gluteal-fold flaps: a case report

A 16-year-old girl with vaginal aplasia had a 1-cm long vaginal pouch and complete absence of uterus. Bilateral subcutaneous based flaps were raised horizontally from the gluteal folds and transposed into the created vaginal cavity. At 12 months follow-up, she had successfully engaged in intercourse and at no time had been mechanically using dilation. At clinical examination, the neo-vagina maintained both adequate length and width.     

Reconstruction of vaginal agenesis by Singapore flap

Summary Various surgical methods for reconstruction of vaginal agenesis have been described in the past. One of these is the neurovascular pudendal thigh flap described by Wee and Joseph [20] after they studied the blood and nerve supply of upper thigh skin, medial groin, and perineum in fresh cadavers. This technique involves elevation of two flaps extending laterally to labia majora in the groin crease and suturing them to each other in the midline after bringing them through tunnels formed under the labia majora, thus, creating a new vagina. In our clinic, 24 cases of vaginal agenesis have been reconstructed with neurovascular pudendal thigh flaps in a period of 33 months. The patients were observed for eight months to three years following the operation, and only in three cases did necrosis of the distal flaps occur; hair grew in the vagina in five cases, and shrinkage was observed in only one case. This rather easy technique is the ideal reconstructive method in the vaginal agenesis. However, hair growth in the vagina must be prevented, since this is the main patient complaint.Presented at the 7th Congress of the European Section of the International Confederation for Plastic and Reconstructive Surgery, Berlin, Germany, June 2–5, 1993