利用新鲜人类羊膜为患有穆勒氏管缺失症(Mayer-Rokitansky-Kuster-Hauser 综合征)的妇女创建新阴道。

IF 2 Q2 OBSTETRICS & GYNECOLOGY Obstetrics and Gynecology Science Pub Date : 2024-11-01 Epub Date: 2024-09-25 DOI:10.5468/ogs.24114
Abdulrahim Gari, Saeed Baradwan, Radiah Iskandarani, Ammar Y Alkhiary, Abdulmalik Abumohssin, Ahmed Abu-Zaid
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引用次数: 0

摘要

目的:有几种移植物可用于构建新阴道。本研究旨在评估在患有 Mayer-Rokitansky-Kuster-Hauser (MRKH) 综合征的女性中使用新鲜人类羊膜构建新阴道的疗效:方法:对十名患者进行了回顾性分析。解剖学成功的定义是术后阴道长度≥5厘米,宽度足以舒适地插入两根手指。当阿拉伯语验证版的性功能指数(FSFI)达到 26.5 分以上时,即为功能成功:手术前的平均阴道长度为 2.15±0.85厘米(范围为 1.5-4.5)。术后阴道平均长度为(5.5±0.53)厘米(范围:5-6),所有患者(10 人)都获得了解剖学上的成功。术后FSFI评分为(29.2±2.4)分,8名患者获得了功能性成功。平均手术时间和估计失血量分别为 83.5±50.31 分钟(范围 42-210)和 122.0±75.69 毫升(范围 20-250)。没有患者需要术中输血或重要器官受伤。四名患者术后 48 小时内出现白细胞增多,一名患者术后出现持续 6 个月以上的慢性盆腔疼痛。术后未出现盆腔脓肿、开放性伤口、慢性阴道分泌物或再次手术等重大并发症:结论:对膀胱直肠间隙进行手术剥离,并利用新鲜人类羊膜在阴道模具上制作新阴道,在技术上是可行和安全的,而且对阴道缺失的 MRKH 患者来说,在解剖学和功能上都有良好的效果。
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Creation of neovagina in women with Müllerian agenesis (Mayer-Rokitansky-Küster-Hauser syndrome) using fresh human amnion.

Objective: Several graft options can be used to construct a neovagina. This study aimed to evaluate the efficacy of creating a neovagina using a fresh human amnion in women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome.

Methods: Ten patients were analyzed retrospectively. Anatomical success was defined by a postoperative vaginal length ≥5 cm, and a width sufficient to comfortably accommodate the insertion of two fingers. Functional success was achieved when a score of >26.5 was attained on the Arabic validated version of the functional sexual function index (FSFI).

Results: Overall, the mean vaginal length before surgery was 2.15±0.85 cm (range, 1.5-4.5). The mean vaginal length after surgery was 5.5±0.53 cm (range, 5-6), and all patients (n=10) achieved anatomical success. The FSFI score after surgery was 29.2±2.4, and eight patients achieved functional success. The mean operative time and estimated blood loss were 83.5±50.31 minutes (range, 42-210) and 122.0±75.69 mL (range, 20-250), respectively. None of the patients required intraoperative blood transfusion or experienced injury to vital organs. Four patients developed postoperative leukocytosis within 48 hours, and one patient experienced chronic pelvic pain that lasted more than 6 months postoperatively. No major postoperative complications, such as pelvic abscesses, open wounds, chronic vaginal discharge, or reoperation, were reported.

Conclusion: In conclusion, surgical dissection of the vesicorectal space and utilization of fresh human amnion to create a neovagina over a vaginal mold are technically feasible and safe, and are linked to favorable anatomical and functional outcomes in MRKH patients with vaginal agenesis.

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来源期刊
Obstetrics and Gynecology Science
Obstetrics and Gynecology Science Medicine-Obstetrics and Gynecology
CiteScore
3.80
自引率
15.80%
发文量
58
审稿时长
16 weeks
期刊介绍: Obstetrics & Gynecology Science (NLM title: Obstet Gynecol Sci) is an international peer-review journal that published basic, translational, clinical research, and clinical practice guideline to promote women’s health and prevent obstetric and gynecologic disorders. The journal has an international editorial board and is published in English on the 15th day of every other month. Submitted manuscripts should not contain previously published material and should not be under consideration for publication elsewhere. The journal has been publishing articles since 1958. The aim of the journal is to publish original articles, reviews, case reports, short communications, letters to the editor, and video articles that have the potential to change the practices in women''s health care. The journal’s main focus is the diagnosis, treatment, prediction, and prevention of obstetric and gynecologic disorders. Because the life expectancy of Korean and Asian women is increasing, the journal''s editors are particularly interested in the health of elderly women in these population groups. The journal also publishes articles about reproductive biology, stem cell research, and artificial intelligence research for women; additionally, it provides insights into the physiology and mechanisms of obstetric and gynecologic diseases.
期刊最新文献
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