ABSTRACT
OBJECTIVE: To investigate the anatomy and sexual outcomes of patients with Mayer-Rokitansky-KüsterHauser(MRKH)syndrome undergoing modified laparoscopic sigmoid vaginoplasty.METHODS: From January 2010 to January 2017,49 MRKH syndrome patients underwent the modified laparoscopic sigmoid vaginoplasty in Guangdong Women and Children's Hospital.Analysis of the anatomy and the sexual outcomes of the neovagina was conducted.The sexual functional outcomes were assessed using the Female Sexual Function Index(FSFI)questionnaire.45 cases of similar-aged women with normal sexual life were selected as controls.RESULTS: Modified laparoscopic sigmoid vaginoplasty was successfully performed in all 49 patients.The mean operative time and intraoperative blood loss was(186±53.7)minutes and(63.8±10.6)mL respectively.The mean length and width of the neovagina at the 6-month followup examination was(12.9±1.56)cm and(3.32±0.33)cm respectively.FSFI score between the MRKH group and the control group:Desire[(4.40±0.59)vs.(4.04±0.71),P0.05],Lubrication[(4.90 ± 0.58)vs.(4.67 ± 0.79),P>0.05],Orgasm[(4.29 ± 0.70)vs.(4.20 ± 0.79),P>0.05],Satisfaction[(4.51 ± 0.82)vs.(4.45 ± 0.91),P>0.05],Comfort[(4.71 ± 0.81)vs.(4.78 ± 0.72),P>0.05],Total score[(27.08 ± 2.83)vs.(26.53 ± 2.98),P>0.05].CONCLUSION: Modified laparoscopic sigmoid vaginoplasty is an effective and safe technique for MRKH syndrome patients,which provides a nearly normal sexual function for patients with MRKH syndrome.
ABSTRACT
<p><b>OBJECTIVE</b>To study the clinical value of optoelectronic cervical cancer screening system (TruScreen, TS) in the screening of cervical cancer in comparison with cervical cytology test.</p><p><b>METHODS</b>A total of 392 patients were screened by TS, Pap, TCT, and HPV using the pathological and colposcopical results as the golden standard. The sensitivity, specificity, Kappa value and the area of under ROC of each method and their combinations (parallel tests) were compared.</p><p><b>RESULTS</b>The sensitivity of TS, Pap, TCT and HPV were 32.2%, 42.2%, 74.4% and 47.8%, with specificity of 96.7%, 93.7%, 78.8% and 84.8% in detecting cervical cancer, respectively. The sensitivity of the parallel tests, namely TCT/HPV, TCT/TS, Pap/TS and HPV/TS were 65.6%, 87.8%, 82.2% and 86.7%, with the specificity of 81.1%, 74.5%, 75.8% and 67.2%, respectively. In light of the areas of under ROC, significant differences were noted between the parallel tests of TS/Pap and TS/TCT (P<0.05), but not between TCT/Pap and TCT/TS (P>0.05); significant differences were found between the parallel tests with TS and those without TS (P<0.05), but not between TS alone and the parallel tests incorporating TS (P>0.05), nor between the 4 parallel tests (P>0.05).</p><p><b>CONCLUSION</b>As a new modality for early screening of cervical carcinoma, TS offers a means for real-time cancer detection with better diagnostic efficacy than Pap and HPV and equivalent efficacy to TCT. The combination of TS and cytological tests can further enhance the diagnostic accuracy.</p>