Amniotic Vaginoplasty

Amniocentesis is mainly for the following situations: 1. Congenital absence of vagina. 2. Uterine or vaginal malignant tumors, most or all of the vaginal resection. Treatment of diseases: congenital without vagina Indication 1. Congenital without vagina. 2. Uterine or vaginal malignant tumors, most or all of the vaginal resection. Preoperative preparation 1. Comprehensive examination of the urinary system. 2. Intestinal preparation: 3 days before surgery, enter the slag diet, oral enteral antibiotics. 3. Vulva, vaginal preparation: Wash the vulva 3 days before surgery, prepare skin 1 day before surgery. 4. Preparation of amniotic membrane: Take fresh amniotic membrane for normal delivery, wash the blood with normal saline, remove the chorion, put the amniotic membrane into antibiotic solution (100ml saline containing penicillin 200,000 u, neomycin 1g), soak about It can be used after 2 hours. 5. Preparation of the prosthesis: The prosthesis must be non-irritating to the tissue, smooth in surface and moderate in size, ensuring no excessive pressure on the surrounding tissue structure during insertion, and at the same time, it can be drained, generally 4 to 5 cm in diameter and about 12 cm in length. Surgical procedure 1. Position and disinfection: the lithotomy position. Routine disinfection of the vulva, vagina. 2. Incision: For congenital non-vaginal, a transverse incision is made between the urethral opening and the anus corresponding to the vaginal opening, which is 4 to 5 cm long. 3. Separation of the bladder rectal space: the left hand indicates the extension into the anus for guidance, and the bladder and the rectal space are separated sharply in the horizontal direction. After separation of about 4 cm deep, the left and right longitudinal blunt dissections are separated by two hands until the deep peritoneum is reached, and the length is at least More than 10cm, the width can accommodate 2 horizontal fingers. 4. Amniotic membrane transplantation and fixation: a prepared amniotic membrane (about 20 ~ 28cm long), wrapped in a vaginal speculum with a condom, the excess amniotic membrane on both sides can be overlapped and gently placed into the forming gap After the iodoform yarn is blocked, the speculum is taken out. Place the catheter. The genital area is fixed with a cotton pad and a T-belt to prevent the artificial vagina from coming out. complication 1. Bleeding: Pay attention to the correct separation of bladder and vaginal space during surgery, which can reduce bleeding, and completely stop bleeding after separation. 2. Injury of the rectum, urethra and bladder: Pay attention to the anatomical relationship of adjacent organs. The anatomical level should be clearly defined during operation to avoid violence. If there is damage, repair it in time. 3. Infection: Strengthen anti-infection after surgery to keep the vulva clean and dry.

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