| Objective: This study was aimed to investigate the incidence trend,clinical features and treatment of each types of reproductive system anomaliesby retrospectively analyzing of the clinical data of761cases. The maintreatment of each type of anomalies and follow-up the operation prognosiswere summarized in order to provide some clinial introductions in the future.Methods: The hospitalized cases of congenital female reproductivesystem anomalies in the second hospital of Hebei University from January2002to December2012were collected. Clinical data of each type wereanalyzed retrospectively. The hospitalized patients who received surgeryoperation treatment from January2007to December2012were followed upby telephone interview. Sexual function of patients performed vaginoplastywere evaluated by using FSFI questionnaire. All data were analyzed by SPSS19.0software. Statistical significance was set at P <0.05.Results: Between January2002and December2012, there were761cases of congentital female reproductive system anomalies:54cases (7.10%)of external genitalia heteroplasia, including20cases (2.63%) of imperforatehymen,34cases (4.47%) of hermaphroditism;335cases (44.02%) of vaginalmalformation, including255cases(33.51%) of mayer-rokitansky-kunster-hauser syndrome(MRKH),39cases (5.12%) of vaginal atresia,23cases (3.02%) of oblique vaginal septum,15cases (1.97%) of transversevaginal septum,3cases (0.39%) of longitudinal vaginal septum;372cases(48.88%) of uterine malformation included334cases (43.89%) of septateuterus,25cases (3.29%) unicornous uterus and rudimentary horn of uterus,8cases (1.05%) of didelphic uterus,2cases (0.26%) of bicornuate uterus,2cases (0.26%) of arcuate uterus and only1case (0.13%) of primordial uterus.65%of the patients who sufferred from imperforate hymen performed of periodic abdominal pain,30%had a manifestation of dysurial;76.47%casesof hermaphroditism had a manifestation of external genitalia heteroplasia;66.87%patients of viganal abnormalities performed of primary amenorrhea,10.75%cases of periodic abdominal pain;48.66%cases of uterineabnormalities performed adverse pregnancy outcomes,22.58%manifested asinfertility,18.82%patients didn’t have any clinical manifestation.Obstructive abnormalities accounted for16.16%(123/761) proportion ofreproductive system abnormalities. The visiting age range from11to44yearsold, the median age was17±9years old. Non-obstructive abnormalitiesaccounted for83.84%(638/761) proportion, the visiting age range from2to50years old, the median age was24±5years old. There was a significantstatistically difference between two groups (P<0.05).12.75%(97/761) reproductive system abnormalities were associated withother system abnormalities, including45.36%urinary system developmentalabnormalities,22.68%skeletal dysplasia,12.37%digestive system dysplasia,9.28%circulatory system developmental abnormalities,6.19%congentialperineal fistula (including the rectum and urethra perineal fistula),2.06%congential cleft lip and palate,2.06%vision and hearing abnormalities.31.25%asymmetric dysplasias were associated with urinary systemabnormalities, while only4.07%proportion in symmetric dysplasia. Therewas a significant statistically difference between two groups (P<0.05).There were249cases of vaginoplasty surgery performed in our hospitalbetween2007-2012years, including184cases of sigmoid vaginoplasty,accounted for73.90%proportion;44cases of peritoneal vaginoplasty,accounted for17.67%; and2.81%for ileum vaginoplasty;2.41%for fetus skinvaginoplasty;1.61%for amnion vaginoplasty. Among the102patients whowere followed up,85cases had sexual life, and the average score of FSFI was25.3±1.04points. The sexual fuction prognosis was well-pleasing.Conclusion:1In761cases, uterine abnormalities were the most common type offemale reproductive system anomalies, followed by vaginal abnormalities. And the least common type was external genitalia abnormality.2The chief complaints of reproductive system anomalies were primaryamenorrhea, adverse pregnancy outcomes, infertility, no obvious symptomsand periodic abdominal pain.3The visiting age of obstructive reproductive abnormalitiy was youngerthan non-obtructive abnormality.4The productive anomalies were more oftenly associated with urinarysystem, skeletal system, digestive system, circulation system, and vision orhearing dysplasia. The proportion was higer in Asymemetry dysplasiaassociated with urinary system dysplasia than symemetry dysplasia.5The most commonly used surgery in reconstructed an artificial vaginawas Sigmoid vaginoplasty. And laparoscopic sigmoid vaginoplasy graduallyreplaced the traditional transabdominal surgery.6Before making a treatment determination of each types of productiveanomalies, we need comprehensive analysis of cilinial symptoms, combinedwith laboratory examination. On the basis of accurate diagnosis, making amost appropriate treatment to relieve the clinical symptoms, improve thepatients’ life quality, fertility and psychological healthy. |
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