Postoperative Long-dated Effect Evaluation Of Two Cervicovaginal Reconstruction For Treating Congenital Cervical Atresia Combined With Complete Vaginal Atresia

Objective:To evaluate the Postoperative long-dated effect of two cervicovaginal reconstructions with part of the labia minora flap and local pudendal thigh flap.Methods:The clinical data of patients with congenital cervical atresia combined with complete vaginal atresia were retrospectively analyzed from March 1984 to August2015 in department of Gynecology,fuyang clinical medical college of Anhui medical university.We choose patients who were treated with cervicovaginal reconstruction with local pudendal thigh flap and part of the labia minora flap as the research object.Primarily, we analysis the general situation of two operations and follow up the Postoperative anatomy of artificial vagina and cervix、Complication、fertility.Then,to evaluate the sexual state throufh FSFI questionnaire,and the impact of the surgery an quality of life through SF-36 scale.At the same time random age matched healthy women as control group.Result:1. Among a total of 20 patients with congenital cervical atresia combined with complete vaginal atresia, 11 patients underwent cervicovaginal reconstruction with part of the labia minora flap(group A), 9 cases of patients accepted cervicovaginal reconstruction with local pudendal thigh flap(group B).2.follow-up results:(1)anatomy:A group of patients with artificial vagina 8-11 cm 1ong,average length 9.20cm±1.21 cm,3cm wide;B group of patients with artificial vagina 8-10 cm long, average length9.12cm±1.60 cm,3cm wide.(2)The sexual state:the total FSFI score of A group was similar to that of B group and control group.In the Desire、Arousal、Lubrication、Orgasm、Satisfaction、Comfort(six separate domains of the functional aspect of female sexuality),The similarity was also observed between three group(P>0.05).(3)The impact of the surgery on quelity of life::A group and B group and control group has significant difference on the dimension of mental health. control group compared between A group and B group with significant difference on the dimension of mental health.There were no statistical differences among the three group on other seven scales.(4)Fertility:Naturally fertilization success, 5 patients had healthy baby after cesarean section at 37 weeks’ pregnancy. In the three months of pregnancy, one patient experienced two spontaneous abortion. Rest patients for failing to reproductive stage so need to continue to follow-up.Conclusions: two cervicovaginal reconstructions with part of the labia minora flap and local pudendal thigh flap are simple,safe, low complication rate and can reach anatomical success.According to the vulvar anatomy of patients,we can choose the suitable operation method. Two kinds of operation can make patients achieve normal female sexual function state, and have no obvious influence on patients quality of life.but whether surgery affect mental health needs to be studied further. Due to limited Surgical cases,the support of the larger sample is necessary.