侧壁隆突法阴道紧缩整形术

目的 为探讨更安全，有效的阴道紧缩整形术的手术方法。方法 采用阴道两侧壁切口，切除松弛的阴道粘膜，环形缝合缩紧阴道侧壁肌肉并形成隆突。结果 共行阴道紧缩整形术23例。随访17例。主客观均感觉效果良好。结论 该方法简单易行，效果确切，能在缩窗阴道内径的同时，使阴道侧壁肌肉隆起，达到增强刺激的目的，一举两得，并能减少并发症的发生。     

侧壁隆突法阴道紧缩整形术

目的　为探讨更安全 ,有效的阴道紧缩整形术的手术方法。方法　采用阴道两侧壁切口 ,切除松弛的阴道粘膜 ,环形缝合缩紧阴道侧壁肌肉并形成隆突。结果　共行阴道紧缩整形术 2 3例 ,随访 17例 ,主客观均感觉效果良好。结论　该方法简单易行 ,效果确切 ,能在缩窄阴道内径的同时 ,使阴道侧壁肌肉隆起 ,达到增强刺激的目的 ,一举两得 ,并能减少并发症的发生     

保全阴道粘膜的阴道紧缩术

目的：对不损伤阴道粘膜的阴道紧缩手术进行部分改良，以提高手术效果。方法：手术应用紧贴阴道粘膜的钝性与锐性相结合的分离，在阴道松弛肌肉的两侧壁缝合紧缩，多余的阴道粘膜形成斜行的粘膜瓣，置于阴道内。结果：1999年至2004年共施术26例，取得良好手术效果。结论：经过改良的保全阴道粘膜的阴道紧缩手术是一种安全有效的手术方法。     

阴道后壁环肌紧缩术治疗产后阴道松弛症

目的：探讨一种有效治疗产后阴道松弛症的手术方法。方法：对阴道后壁撕裂松弛的肌肉由内向外采用水平褥式紧缩缝合法,缩小阴道直径;由深至浅,采用纵向紧缩缝合法,缩小阴道口并延长会阴体。结果：将此法用于56例产后阴道松弛症患者,手术全部成功。术后随访6～12个月,患者无不适感,术后效果满意。结论：阴道后壁环肌紧缩术治疗产后阴道松弛症,既达到解剖上的缩窄,同时也达到功能的康复,效果确切。     

保留阴道黏膜阴道紧缩术97例报告

目的 介绍一种保留阴道黏膜的阴道紧缩术方法.方法 于阴道口处女膜痕外5 mm处行切口,不切除阴道黏膜,紧缩阴道侧后壁肌肉,连续褥式缝合剥离阴道黏膜及黏膜下组织,将保留的阴道黏膜及黏膜下组织突入阴道.结果 本组共97例患者,术后随访3个月至6年,均感术后性生活满意,效果良好.结论 该手术方法操作简单,疗效确切、可靠,值得临床推广应用.     

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。     

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。     

梯形缝合法阴道紧缩术应用探讨

目的:探究阴道缩窄术的最佳手术方式。方法:采用梯形缝合法即对阴道后壁呈梯形样三层缝合使阴道下1/3段及阴道口肌肉紧缩的手术方式。结果:治疗30例,阴道松弛症状均取得了良好的矫治效果。结论:梯形缝合法将直肠筋膜、阴道周围缩紧加强的同时,更着重于加强阴道外1/3段,特别是近阴道口肌肉的力量使其更加符合生理特性,提高性生活的质量。该法是治疗阴道松弛症较好的手术方法。     

保留完整阴道粘膜的阴道紧缩术

阴道紧缩术是性快感强化手术之一，传统的方法是将阴道后壁的粘膜菱形切除。但此术式术后存在许多弊端，笔者自1998年以来，采用保留完整阴道粘膜的阴道紧缩术，治疗28例患者，术后效果满意，现报道如下。     

提肛肌法和肛门括约肌法并用行黏膜下阴道紧缩术

阴道松弛症是因分娩、外伤及自然老化而造成的阴道周围肌肉损伤所致。自1990年以来，我们对345例患者采用提舡肌法和舡门括约肌法并用行黏膜下阴道紧缩术，效果满意。     

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。     

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。     

球海绵体肌法治疗产后阴道松弛症

目的：探讨一种实用有效的治疗产后阴道松弛症的方法和效果。方法：采用经阴道口后壁皮肤与粘膜交界处切开,剥离随访膜,分离出撕裂的球海绵体,形成肌瓣。将肌瓣折叠缝合,纵形缝合阴道粘膜,使形成隆突,保留阴道粘膜。结果：本组20例患者均采用球海绵体肌肌瓣重叠缝合法行阴道缩窄术。18例患者术后6个月～3年随访,性生活质量均有明显提高,效果较满意。结论：本术式可以治疗阴道松弛症,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的较好方法。     

Rectus fascia colpopexy for complete prolapse of the vaginal vault after hysterectomy

A simple operation, anterior abdominal wall colpopexy using autogenous strips of rectus fascia, to repair posthysterectomy prolapse of the vaginal vault, is described. It is mainly indicated for patients with complete vaginal eversion, in whom preservation of a physiologically useful vagina is highly desirable. Normal vaginal caliber and depth were secured and no recurrence has arisen in a series of nine patients operated upon for complete prolapse of the vaginal vault after hysterectomy, seven of whom have been followed up for six months to 12 years.     

Tension-free vaginal tape for surgical treatment of stress urinary incontinence: Two years follow-up

BACKGROUND: The objective was to study prospectively the effectiveness of tension-free vaginal tape as an ambulatory and minimal invasive operation for the treatment of female stress incontinence. METHODS: The tension-free vaginal tape procedure was performed in 25 patients with genuine stress incontinence and they were followed for a 2-year period. All patients were diagnosed with urodynamics to have genuine stress incontinence. Pad tests, cough stress test and quality-of-life assessments were carried out in all patients, both preoperatively and postoperatively. The majority of the women were discharged the morning after the surgical procedure. RESULTS: Twenty of 25 (80%) patients were found to be cured 2 years after the operation. The vaginal tape was spontaneously dropped out from the vagina in one patient 2 weeks after the procedure. We did not see such a complication in previous studies. CONCLUSION: We conclude that the tension-free vaginal tape procedure is both a safe and effective method to cure genuine female stress incontinence. Furthermore, it can be performed as an ambulatory procedure under local anesthesia with a short operative time.     

带血管蒂乙状结肠代阴道术

目的 探讨应用带血管蒂乙状结肠再造阴道的技术及效果。方法 2009年2月至2014年9月,我院对13例先天性无阴道女性患者行带血管蒂乙状结肠代阴道术。术后定期随访,进行体格检查、性生活满意度和患者满意度调查。结果 13例手术均获成功,术后外阴形态良好,再造阴道长度10~12 cm,阴道直径约3 cm,阴道壁柔软、湿润,有弹性。随访8~75个月,10例术后有性生活。总体手术满意率高。结论 应用带血管蒂乙状结肠移植作为再造阴道的衬壁,是一种行之有效的阴道再造方法。     

乙状结肠法人工阴道成形术558例报告

目的：报道乙状结肠法人工阴道成形术的手术方法及效果。方法：按盆腔深度＋1／2系膜长度的公式计算出切取乙状结肠的长度；人工阴道造穴由阴腹联合进行；移植肠段下植端另行开口形成人工阴道外口。结果：手术成功率为98．92％，人工阴道深度，宽度均合乎生理要求，大部分人工阴道粘膜组织结构，细胞形态无异常变化，人工阴道与自然阴道中的人乳头状瘤病毒（HPV）检出率无差异，人工阴道粘膜中未检出雌激素受体（ER）。结论：乙状结肠法人工阴道成形术手术方法先进可靠，所形成的阴道符合正常的解剖，生理要求，效果最佳，患乐于接受。     

直肠阴道隔严重粘连的腹腔镜辅助下阴式全子宫切除36例报告

目的探讨直肠阴道隔严重粘连的腹腔镜辅助下阴式全子宫切除的可行性。方法腹腔镜下离断子宫圆韧带、卵巢固有韧带、输卵管及子宫血管,初步钝性分离子宫直肠间隙,至致密粘连处停止分离,转阴式手术。切开阴道黏膜后先分离宫颈与阴道间隙至腹腔,离断子宫骶韧带及主韧带后,自子宫主韧带断端水平截除宫颈,从已打开的子宫前穹隆翻转子宫,自阴道前穹隆翻出子宫,暴露子宫后壁与直肠粘连,直视下沿子宫后壁锐性剪开、分离并切除粘连组织。结果 35例腹腔镜辅助下阴式子宫切除术顺利完成,1例因子宫直肠间隙粘连严重,镜下及经阴道分离时出血多而中转开腹。35例手术时间(134±38)min,术中出血(138±36)ml,无直肠及膀胱输尿管损伤。35例随访12～36个月,平均18.5月,33例完整切除病灶者预后良好,2例未能完整切除病灶者症状缓解,病灶持续存在。结论自阴道前穹隆翻出子宫,暴露子宫后壁与直肠粘连,在直视下切除直肠阴道隔严重粘连的全子宫可行,提高了手术的安全性。     

A new needle suspension procedure for genuine stress incontinence and anterior vaginal wall prolapse

A new suspension method was developed for the correction of anterior vaginal wall relaxation and genuine stress incontinence. This procedure suspends the anterior vaginal wall to the anterior rectus fascia, and in doing so gives support to the bladder neck, anterior vaginal wall and vaginal apex. The procedure is performed at the time of vaginal hysterectomy or correction of anterior vaginal wall relaxation. The authors present their experience with this technique in 31 patients.Editorial Comment: Numerous types of surgery for the simultaneous correction of stress incontinence and cystocele and/or procidentia have been described in the literature. Some have proved more efficient for the correction of stress incontinence and others for the correction of disturbed pelvic support. The authors use the known method of needle suspension for the correction of stress incontinence, but for the new purpose of correction of cystocele/procidentia and stress incontinence. If necessary, vaginal hysterectomy can be performed with the originally planned intervention. As the criterion of an efficient outcome for the correction of genital statics, the author uses a vaginal depth of greater than 5 cm, which is less than normal. The successful correction of genital statics after 24 months was reported to be 93%, which is an extremely favorable result, resembling the success rate achieved by much more complicated surgeries (e.g. sacrospinous vault fixation or fixation of the vagina to the sacrum). The successful correction of stress incontinence in 82% of patients after 24 months is also favorable, and comparable to the results achieved by other surgical methods of needle suspension for the correction of stress incontinence.