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     

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。     

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。     

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。     

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。     

阴道口切口阴道松弛整形术

目的：探讨一种阴道粘膜同无手术瘢痕的阴道松驰整形术式。方法：临床应用9例，取阴道粘膜与皮肤移行处为切口，行阴道粘膜下锐性分离，将阴道肌层拉拢缝合，间断缝合皮肤与粘膜切口。结果：术后随访6-12个月，愈合好，无不适，性生活满意。结论：此术式可减轻术区创伤又避免阴道粘膜手术瘢痕，效果良好。     

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。     

小切口保留完整粘膜阴道紧缩术

目的:探究阴道缩窄的最佳手术方式。方法:采用小切口并保留完整阴道粘膜的术式,对阴道后壁多层缝合,使阴道外1/3及阴道口得以收紧。结果:将此法应用于105例阴道松弛患者,手术全部成功,术后随访0.5～3年,效果满意。结论:小切口保留完整粘膜阴道紧缩术在收紧阴道肌肉的基础上,着重于对阴道外1/3及阴道口的收紧,更符合生理特性,提高性生活质量,效果确切。     

组织工程技术在阴道再造中的应用

对于许多的阴道异常情况通常需广泛的外科手术重建。但传统的各种术式及非阴道组织被应用于阴道再造必然会导致其功能的局限性，且同时会损伤供区。应用组织工程技术可为阴道再造提供组织来源，组织工程化阴道与正常阴道组织相近，具有显著的优势。本文结合国内外关于组织工程应用的文献报道，着眼于阴道组织工程的应用技术及发展前景进行综述。     

Transverse vaginal septum: Case report and review of the literature

A case of perforated complete transverse vaginal septum in the upper third of the vagina in a patient presenting at 19 years of age for evaluation of primary infertility. Diagnosis was made by hysterosal-pingography. The patient was treated surgically and conceived 2 months after the procedure. The finding of transverse vaginal septum in an asymptomatic infertility patient is highly unusual. We reviewed the literature since 1966 and summarized 73 cases. The review confirms the benign characteristics of this rare anomaly and supports the embryonic origin of the transverse septum from the vaginal plate.     

会阴体重建阴道紧缩术的临床应用分析

目的:分析会阴体重建阴道紧缩术的方法及临床作用.方法:手术采用阴道口入路,立体分段缝合、紧缩盆底肌相关段,重建会阴体结构.术后10天拆线、2月后开始性生活.结果:自2006年8月～2008年7月,应用本文术式完成治疗阴道松弛患者92例,无血肿及感染等临床并发症,伤口愈合良好.随访41例,最短者术后9个月,最长者术后16个月.均述肛缩有力,阴道收缩能力、阴道壁张力增强,性生活质量明显提高.结论:应用会阴体重建阴道紧缩术治疗产后会阴体损伤、阴道松弛,针对性强,设计合理,操作简便,效果明显.     

阴道成形术后阴道模具固定带的制作及应用

目的探讨自制阴道模具固定带在阴道成形术后患者中的应用效果。方法将57例先天性无阴道综合征并行阴道成形术患者按住院号尾数奇偶分为观察组29例和对照组28例,术后分别使用自行设计的固定带和普通卫生带固定阴道模具。随访6个月评价效果。结果观察组阴道长度和成熟率显著高于对照组,模具脱出率显著低于对照组,佩戴耐受率显著高于对照组(均P0.05);观察组术后并发症(阴道狭窄、粘连、感染和闭锁)发生率低于对照组。结论先天性无阴道综合征患者阴道成形术后使用新型固定带可以减少模具脱出率,降低术后并发症,提高佩戴耐受率,从而促进阴道成熟。     

Pressure measurements during pelvic floor muscle contractions: The effect of different positions of the vaginal measuring device

The purpose of the present investigation was to assess whether different positions of the vaginal measuring device affect the pressure readings during pelvic floor muscle (PFM) contraction. Twelve women with stress urinary incontinence (SUI) participating in a PFM exercise program, volunteered for the study. The diagnosis of SUI was based on urodynamic investigation and pad test. The mean age of the women was 40.9 years (24–50). The women performed three PFM contractions with a vaginal balloon placed in four different positions: 1) against the vaginal vault and in the posterior fornix, 2) in the proximal upper third of the vagina, 3) with the middle of the balloon 3.5 cm from the introitus vagina and 4) with half of the balloon outside the introitus vagina. The results demonstrated significant differences between recordings from the four vaginal positions: position 1, median pressure 5 cm H₂O; position 2, 9 cm H₂O; position 3, 15 cm H₂O; and position 4, 8 cm H₂O. It is concluded that the position of the vaginal device affects the results. This may be one important factor which could explain the variability of vaginal pressure recordings during PFM contractions. For most women the highest pressure was recorded in position 3. © 1992 Wiley-Liss, Inc.     

Candida albicans: the estrogen target for vaginal colonization

BACKGROUND: Estradiol (E(2)) stimulates colonization of the vagina by Candida albicans. Although this yeast expresses an estrogen-binding protein (EBP), the cellular target for estrogenic modulation of this infection is unresolved. Findings support direct E(2)-induced C. albicans growth as well as indirect effects via E(2)-induced changes in the vaginal epithelium. Our primary goal was to pursue the issue of direct versus indirect estrogen action on vaginal candidiasis using diethylstilbestrol (DES), an efficacious mammalian estrogen receptor agonist, which exhibits no detectable affinity for the EBP of C. albicans. METHODS: We used both in vitro and in vivo experimentation with an EBP-positive strain of C. albicans isolated from the human vagina. Ligand-binding studies were performed with steroidal and nonsteroidal estrogens and anti-estrogens using the soluble EBP from both the yeast and the rat uterus. Mature ovariectomized rats were treated with either E(2) or DES for 7 days before and after C. albicans inoculation into the vaginas. Subsequent estrogen-sensitive colonization was quantified based on cultures of vaginal homogenates on Sabouraud dextrose (SD) agar pour plates. RESULTS: We confirmed that our isolate of C. albicans contained a high-affinity EBP, with no detectable affinity for DES. Vaginal colonization by C. albicans was 8.6-fold greater in response to in vivo treatment with E(2) than with the comparable dose regimen of DES. CONCLUSIONS: The mechanism for estrogen-sensitive vaginal colonization by C. albicans includes a functional ligand-EBP interaction within the yeast.     

Secondary reconstruction of vaginal stenosis with bilateral pudendal thigh flaps

Abstract

We report the cases of two patients who had pronounced stenosis of the lower part of the vagina after vaginal reconstruction for congenital vaginal aplasia and hypoplasia. Bilateral pudendal thigh flaps were used for secondary reconstruction, and gave satisfactory results with no signs of recurrence or severe scarring at the donor site.