The Clinical Analysis Of Female Congenital Vagina Heteroplasia

Object:Congenital vagina heteroplasia is one of common type of the female genital duct abnormalityes. Clinically, vaginal heteroplasia symptoms are multiple and dormant. The patients have normally developed and functioning ovaries,as well as secondary sexual characteristics. Therefore, the correct diagnosis and proper treatment to improve the quality of life and prognosis in patients with congenital vagina dysplasia are crucial importance. This study was aimed to analysis the incidence, clinical features, treatment and prognosis by retrospectively analyzing of the clinical data, so as to provide guidance for clinical work.Methods:188 congenital vagina heteroplasia patients were included in the study. To summarize the incidence, clinical characteristics, treatment and prognosis of each type of congenital vaginal dysplasia (congenital absence of vagina, vaginal atresia, oblique vaginal septum, longitudinal vaginal septum,transverse vaginal septum).Through outpatient and telephone interview follow-up 64 patients with postoperative situation(including sexual satisfaction, procreation, etc.) are studied. Statistical analysis of data by SPSS20.0.Results:1. Between December 2005 to January 2016, there were 188 cases of congenital vagina heteroplasia:75 cases(39.89%) of congenital absence of vagina,52 cases(27.66%) of oblique vaginal septum syndrome,35 cases(18.62%) of vaginal atresia,19 cases(10.11%) of longitudinal vaginal septum,and 7cases(3.72%) of transverse vaginal septum.98.67%cases of mayer-rikitansky-kuater-hauser syndrome patients have absence of vagina or rudimentary uterus, renal agenesis ipsilateral to imperforate 100% in all oblique vaginal septum syndrome patients.2.146 cases performed were the following:28.19% of patients who suffered from primary amenorrhea in an otherwise normally developed adolescent female,22.87%had abdominal pain,11.17% irregular vagina bleeding and flowing,6.91% performed dysmenorrhea,3.19% had dyspareunia,3.19% manifested as infertility,2.13% suffered from urinary discomfortable,22.35% patients didn’t have clinical manifestation.3.84%(63/75)had MRKH type I,the median age was 25.41±4.46 years,16% (12/75) had MRKH type II,the median was 28.92±7.50years, and 2.67%(2/75) had MURCS syndrome,then type I is more common than type 11.55.77%(29/52) had OVSS type Ⅰ, the median age was 20.93±6.45years,36.54%(19/52) type Ⅱ, 7.69%(4/52) type Ⅲ, two groups median age was 21.78±6.35years, there was not statistically significant difference between two groups(P>0.05).82.86% (29/35) vaginal atresia type I, the median visiting age was 13.24±1.96years, 8.57%(3/35) type Ⅱ, the visiting age was 16-22 years.4. The analysis of treatment of congenital vagina heteroplasia is as follows: surgical correction of deformity were performed in 138 cases, surgery rate up to 73.40%.54 cases (72%) of peritoneal vaginoplasty,1 cases of sigmoid vaginoplasty,and among peritoneal vaginoplasty 23 cases (42.59%) were performed by laparoscopy,31 cases (57.41%) were preformed by laparotomy. There was a statistically significant in operative time and intraoperative bleeding(P< 0.05), but postoperative length of stay has not statistically significant(P>0.05).There were no intraoperative comlications. The patients who were followed up,were well-pleasing about sexual demand.Conclusion:1.In 188 cases, mayer-rikitansky-kiiater-hauser syndrome were the most common type of female congenital vagina heteroplasia, followed by oblique vaginal septum syndrome, vaginal atresia,longitudinal vaginal septum. And the least common type were transverse vaginal septum.2.The chief complaints of congenital vagina heteroplasia were nomenstrual after puberty(primary amenorrhea),abdominal pain (periodic),irregular vagina bleeding or flowing,and dysmenorrhea, etc.3.Congenital vagina heteroplasia were usually associated with other system malformation,urinary system dysplasia is common,and renal agenesis ipsilateral to imperforate 100% in oblique vaginal septum syndrome patients.4.Laparoscopic autologous peritoneal vaginoplasty has a small surgical trauma,less intraoperative bleeding and postoperative time,small scars and higher postoperative sexual satisfaction etc.Which is the main vaginoplasty type.5.Clinical symptoms of congenital vagina heteroplasia are various and diversity, so it is absolutely essential to improve the prognosis of the patient’s quality of life by correct diagnosis and proper treatment.