女性生殖道梗阻性畸形

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处女膜闭锁,主要由泌尿生殖窦发育异常引起,表现为周期性疼痛、闭经等。当出现阴道积血时,体检发现处女膜封闭并呈一浅蓝色凸起即可诊断,于靠近处女膜环处切开,充分引流或吸净积血后,将阴道粘膜缝合到处女膜坏处以防复发。阴道畸形:阴道横限可能由泌尿生殖窦或苗勒氏管融合或管道化异常引起,最多见于阴道上段(46%).可引起经血倒流,性交困难,子宫或输卵管积脓、子宫内膜炎等。超声及核磁共振有助于诊断。对小的横隔可行切除术,或成形术。苗勒氏管发育不全:可引起阴道发育不全及苗勒氏管不融合,发生率1/500O0,阴道呈一小凹陷,阴道上段缺失,而染色体、激素水平、第二性征正常,常合并尿道或肾脏畸形(互5%~40%)或骨骼发有异常(12~50%),可使用Frank法(使用扩张器)或手术治疗:最常用MeIndroc阴道成形术(臀部皮瓣移植)。宫颈缺如:党合并阴道上段缺如,引起闭经,疼痛以至子宫内膜异位,子宫扩张等。超声、MRI有助诊断。治疗是形成上皮化的宫颈和阴道通道.术后口服避孕药直至生育,也有输卵管内合子移植成功受孕的报道。子宫畸形:残角子宫可行腹腔镜切除;子宫融合畸形患者可发生一侧阴道积血合并同侧肾脏发育不全,手术切开梗阻侧阴道引流后切除阴道纵隔,对阴道粘膜进 Hymen atresia, mainly caused by urogenital sinus dysplasia, manifested as periodic pain, amenorrhea and so on. When there is vaginal hemorrhage, the examination revealed hymen closed and showed a light blue bulge can be diagnosed in the hymen near the ring at the cut, the full drainage or suction net hematuria, the vaginal mucosa suture to the hymen damage to prevent recurrence . Vaginal deformity: Vaginal cross may be caused by urogenital or Müllerian fusion or ductal abnormalities, most often seen in the upper vagina (46%). Can cause blood back, difficulty in sexual intercourse, uterus or tubal empyema, endometritis and so on. Ultrasound and MRI help diagnose. Possible resection of small transverse septum, or angioplasty. Müllerian duct hypoplasia: can cause vaginal hypoplasia and Muller’s tube is not fusion, the incidence of 1 / 500O0, vaginal was a small depression, missing the upper vagina, and chromosomes, hormone levels, the second character is normal, often combined Urethral or renal malformations (between 5% and 40%) or abnormalities in the skeleton (12 to 50%) can be performed using the Frank method with a dilator or surgery: The most commonly used Mendrocrocostomy (hip flap). Cervical absence: the party merged vaginal absence, causing amenorrhea, pain and endometriosis, uterine expansion. Ultrasound, MRI helps diagnose. Treatment is the formation of epithelial cervical and vaginal channels. Postoperative oral contraceptives until birth, there are reports of successful tubal zygotic transplantion. Uterine malformations: Residual angle uterus feasible laparoscopic resection; patients with uterine fusion deformity can occur on one side of vaginal hemorrhage with ipsilateral renal hypoplasia, surgical excision of the vaginal drainage of the vaginal mediastinal resection, the vaginal mucosa into
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