摘要目的 探讨更安全有效的治疗阴道松弛的阴道紧缩手术方法.方法 对132例因阴道松弛导致性生活质量下降,要求行阴道紧缩手术的患者进行改良的阴道缩紧术.手术对松弛的阴道前壁和后壁的肌肉及筋膜进行切实有效修复,同时修复会阴裂伤.对合并张力性尿失禁的患者,根据尿道中断吊床学说理论,在修复前壁时于尿道中段加强缝合肌肉筋膜1针;对合并便秘患者,在后壁修复时加强缝合肛提肌3针;前后壁修复时最大限度保护阴道黏膜.结果 术后2～7年,随访118例对术后改善性生活满意度、张力性尿失禁、便秘及阴道排气4项内容进行问卷调查,收到满意的临床效果.结论 手术方法设计专业,疗效确切,患者满意度高,适合有经验的专科医师采用.

abstractsObjective To explore more effective methods in vaginal tightening surgery for vaginal relaxation treatment. Methods 132 cases of patients who suffered the decline in quality of sex life owing to vaginal relaxation, requiring improved vaginal tightening surgery. The vaginal surgery was performed to repair the muscles and fascia of the anterior and posterior walls effectively, meanwhile the perineal laceration was also repaired. According to the "hammock" theory of the treatment of urethral disruption, patients with urinary incontinence with tension was treated to strengthen one suture needle on muscle fascia in the middle of urethra, when repairing anterior of vagina. For patients with constipation, the posterior of vagina was repaired to strengthen 3 suture needles on levator ani during repairing the anterior and posterior wall, so that the vaginal mucosa could get maximum protection. Results 118 patients had been followed up for 2-7 years. A questionnaire survey was conducted about four elements targeted on improving sexual satisfaction, tension incontinence, constipation and vaginal discharge. The clinical results were satisfactory. Conclusions The surgical design is professional and highly effective, and the patients are satisfied with the results. It is suitable for experienced specialists to perform the procedures.