ABSTRACT
With the development of social economy and the progress of medical technology, more and more women begin to accept vaginal contraction due to the harmony of sexual life. Now, surgical procedures for vaginal contraction includes resection of posterior vaginal mucosa, contraction without injury of vaginal mucosa, and contraction with embedded vaginal thread. This review aims to summurize the anatomic structure of vagina and the mechanism of vaginal relaxation, as well as the basic operative methods and development of vaginal contraction. The related literature on vaginal contraction at home and abroad was summarized. Different surgical methods have their own advantages and disadvantages.
ABSTRACT
Objetivo: Estimar la longitud promedio de vagina, del hiato genital y cuerpo perineal en mujeres nulíparas. Diseño: Estudio descriptivo transversal con muestreo por conveniencia. Institución: Departamento de Ginecología y Obstetricia, Hospital Nacional Cayetano Heredia, Lima, Perú. Participantes: Mujeres nulíparas. Métodos: En 85 mujeres nulíparas atendidas en el Hospital entre enero y marzo 2014, en edad fértil, que habían iniciado relaciones coitales vaginales y que requerían evaluación ginecológica, se realizó medición del peso y talla. En posición de litotomía, se midió con un hisopo milimetrado la longitud total de la vagina, hiato genital y el cuerpo perineal. Las mediciones fueron realizadas por un solo examinador. La participación fue completamente voluntaria y con firma de consentimiento informado. Principales medidas de resultados: Longitud total de la vagina, hiato genital y el cuerpo perineal. Resultados: La media de la longitud total de vagina fue 8,1 ± 1,4 cm (DE), del hiato genital 2,2 ± 0,5 cm (DE) y del cuerpo perineal 2,3 ± 0,5 cm (DE). Conclusiones: Las medidas estimadas no difieren con resultados de estudios internacionales. Se requiere estudiar una mayor muestra de pacientes de las diferentes regiones para tener un estimado más representativo de estas medidas en pacientes nulíparas del Perú.
Objectives: To determine vaginal, genital hiatus and perineal body length in nulliparous women. Design: Cross-sectional descriptive study with convenience sample. Setting: Department of Obstetrics and Gynecology, Hospital Nacional Cayetano Heredia, Lima, Peru. Participants: Nulliparous women. Methods: From January through March 2014 in 85 nulliparous women in childbearing age who had coital sex and required gynecological evaluation, weight and height were obtained and length of vagina, genital hiatus and perineal body were measured with a graph swab in lithotomy position. Measurements were obtained by one single examiner. Participation was voluntary with signed informed consent. Main outcome measures: Length of vagina, genital hiatus and perineal body. Results: Average length of patients vagina was 8.1 ± 1.4 cm (SD), genital hiatus 2.2 ± 0.5 cm (SD), and perineal body 2.3 ± 0.5 cm (SD). Conclusions: Measures obtained did not differ from international studies. A broad population study is suggested to better estimate these measures in nulliparous Peruvian women.
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Objective To explore the related pelvic floor anatomy to the pathological vaginal relaxation and key points of the vaginal tightening surgery.Methods The vaginal tightening surgery was performed in 24 cases of vaginal relaxation.The key points of this operation included levator ani muscle suturation and perineal body reconstruction,and anal sphincter reconstruction as in case of the muscle injury grade Ⅲ.Results The degree of levator ani muscle separation was positively correlated with that of vaginal relaxation in all the 24 cases.18 cases were followed up from 6 months to 2 years,and had no complications of rectovaginal fistula and infections.The average level of perineal body was increased from 2.3 cm to 3.5 cm.Vaginal length of 6 cm from vaginal orifice was proper with good tightness.The patients felt strong anal contraction,enhanced ability of vaginal tightening and improved quality of sex life.There were no more infections of genitourinary tract.Conclusions Through levator ani muscle suturation and perineal body reconstruction,it can get the vaginal tightening effect.
ABSTRACT
Thirteen women with rectovaginal fistulas unrelated to inflammatory bowel disease or previous radiotherapy were operated on during Jan. 1993 - Jul. 1997 at Song-Do Colorectal Hospital. The mean age was 36.9 (range, 25~56) years. The mean follow-up after operation was 33 (range, 8~62) months. The etiology of the fistula in the majority of patients was obstetric injury and operative trauma (10/13). Seven patients were referred after attempts at repair elsewhere. Eleven patients were managed with a mucosal flap advancement and a 3-layered repair of the rectovaginal septum: 4 without and 7 with a perineal body reconstruction or sphincter repair. Two patients were managed with a mucosal flap advancement only without a repair of rectovaginal septum. In all cases, a concomitant colostomy was not performed. Postoperative complications were noticed in 3 of the patients managed by a mucosal flap advancement and 3-layered repair of the rectovaginal septum with perineal body reconstruction or sphincter repair and all were perineal wound infections. All of these infections were cured, without recurrence, by simple rubber seton drainage. Recurrence occurred in one case managed by a mucosal flap advancement only. Three patients with liquid incontinence became continent after a sphincter reconstruction. We conclude that most rectovaginal fistulas unrelated to inflammatory bowel disease or previous radiotherapy can be managed with a mucosal flap advancement and 3-layered reconstruction of the rectovaginal septum. If any signs or symptoms of sphincter injury are noticed preoperatively while taking the patient's history or during manometry and endorectal ultrasonography, a perineal body reconstruction or sphincter repair should be performed.