Analysis Of The Efficacy And Body Image Changes Of Two Vaginoplasty

Research backgroundMRKH syndrome is often referred to as congenital absence of vagina.Patients often present with primary amenorrhea and sexual intercourse difficulties.The purpose of treatment is to establish a new vagina to meet the patient's sexual needs.At present,vaginoplasty has been carried out for more than 100 years,and more than20 kinds of surgical methods have been developed.Postoperative quality of sexual life and evaluation of self-body image have become a close concern of scholars at home and abroad.This study mainly compares the two surgical methods performed in our hospital.ObjectiveTo investigate the curative effect of laparoscopic peritoneal vaginoplasty and ileal vaginoplasty,the effect of postoperative on the quality of sexual life,and the understanding of the changes in self-body image.The purpose is to provide experience in selecting appropriate surgical procedures for patients with MRKH syndrome.Materials and methods1 Study objectA total of 90 patients with Mayer-Rokitansk-Kustner-Hauser syndrome at the Third Affiliated Hospital of Zhengzhou University from January 2013 to January2018,of which 76 patients were treated through surgery and were able to complete postoperative follow-up.According to different surgical methods,it is divided into laparoscopic peritoneal vaginoplasty group(abbreviated as peritoneum group)and abdominal ileoplasty group(abbreviated as ileum group).36 cases of peritoneal group,age 24.58±3.46 years old,BMI is 23.10±2.42kg/m~2,8 married,28 unmarried,13people have vestibular crypts of varying length,7 have primordial uterus;40 cases of ileum group,age is 23.75±3.56 years old,BMI is 22.61±2.67kg/m~2,6 married,34unmarried,12 have vestibule crypts of varying lengths,and 10 have primordial uterus.2 Study analysisObservation indexes:the time of operation,the amount of bleeding,the time of hospitalization,the time of exhaust,postoperative vaginal length and postoperative adverse reactions.The postoperative quality of sexual life was evaluated by using the femalesexual function index(FSFI).Using the Modified Body Image Scale(MBIS)to study the evaluation of patients self-image before and after surgery.3 Statistical analysisData collection was performed using the Excel form,and the entered data was analyzed using SPSS 22.0 statistical software.Measurement data were observed by x±s for normal distribution,and independent sample t-test was used for comparison between the two groups.The count data was analyzed by chi-square test,and the theoretical frequency was too small to be tested by Fisher's exact probability method.The test level was?=0.05,P<0.05 was considered statistically significant.Result1.The proportion of MRKH1 patients in this study was 52/76(68%),and that in MRKH2 patients was 24/76(32%).There were no MRKH3 patients in this study.2.The intraoperative blood loss of the peritoneal group was less than that of the ileum group.The postoperative hospital stay and postoperative exhaust time were shorter than that of the ileum group.(P<0.05).3.In the ileum group,20%(8/40)patients had more vaginal discharge,12.5%(8/40)patients had different degrees of intestinal obstruction after operation,and 8%(3/36)after peritoneal surgery.The patient developed vaginal apex polyps,and both groups had different proportions of fever?urinary retention and vaginal contracture after surgery.4.The postoperative FSFI score was 27.41±1.76 in the peritoneal group and26.67±2.28 in the ileum group.There was no significant difference in the total score(P>0.05).In the peritoneal group,the scores of sexual desire and sexual satisfaction were higher than those of the ileum group.In the vaginal lubrication degree,the peritoneal group scored lower than the ileum group,and the difference was statistically significant(P<0.05).In sexual arousal,orgasm.There were no significant differences in sexual pain and other aspects(P>0.05).5.The total score of MBIS before treatment in the peritoneum group was19.28±2.01 points,and the total score after treatment was 8.14±1.20 points.The total score before treatment in the ileum group was 19.48±1.75 points,and the score after treatment was 9.65±1.31 points.There was no significant difference in MBIS score between the two groups before treatment(P>0.05).The body image of the peritoneal group was better than that of the ileum group after treatment(P<0.05).The MBIS scores of the two groups were significantly improved after treatment,and the difference was statistically significant(P<0.05).Conclusion1.Two kinds of vaginoplasty are effective in treating MRKH syndrome.In the peritoneal group,hemorrhage,postoperative hospital stay,postoperative exhaust time,and postoperative adverse reactions were superior to the ileum group.2.Both postoperative vaginal anatomy and function can meet the needs of patients'sexual life.3.MRKH syndrome seriously affects the evaluation of female patients'self-body image.The evaluation of female self-body image after vaginoplasty is better than before.The evaluation of peritoneal group is better than that of ileum group.