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02 April 2018, Volume 34 Issue 4 Previous Issue    Next Issue

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New classifications for female genital tract malformations DENG Shan 2018, 34(4): 361-367.  DOI: 10.19538/j.fk2018040104 Abstract ( )   Female genital tract malformations are a large group of congenital structural abnormalities that involve the uterus，cervix，vagina and fallopian tubes，and are often combined with organs other than the reproductive tract.Due to the close relationship between embryonic development of Mullerian duct and mesonephric or Wolffian duct as well as the urinary system，renal malformations are the most common malformations.Classification of different malformations at present mainly depends on the structure characteristics and clinical manifestations，considering the embryonic basis at the same time.The most representative classifications include the American Fertility Society（AFS）classification（1988），VCUAM classification（2005）and the European Society of Human Reproduction and Embryology and European Association for Gynecological Endoscopy（ESHRE/ESGE）classification（2013）.This paper is to review and comment the characteristics，advantages and limitations of each classification system.

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Diagnosis and management of uterine malformation XIA En-lan 2018, 34(4): 367-371.  DOI: 10.19538/j.fk2018040105 Abstract ( )   Congenital uterine malformation can lead to infertility and recurrent miscarriage.The traditional treatment for uterine malformation is laparotomy.Nowadays hysteroscopic metroplasty has replaced the traditional laparotomy to treat uterine anomaly，and become the most effective treatment for uterine malformation.After metroplasty the reproductive outcome is ameliorated obviously.Attention should be paid to uterine rupture and cervical incompetence during pregnancy after metroplasty.

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Hysteroscopic septum insection in the treatment of septate uterus WANG Su-min，GU Xiao-yan 2018, 34(4): 371-374.  DOI: 10.19538/j.fk2018040106 Abstract ( )   The gold standard method for diagnosing septate uterus is the laparoscopy and hysteroscopy.This paper presents our surgical technique for the insection of uterine septum，and 190 cases of patients with uterine septum were included in our retrospective analysis.Hysteroscopic septum insection can reduce subsequent miscarriage rates and improve live-birth rates.Hysteroscopic metroplasty of uterine septum is safe with fewer complications.The reproductive prognosis in the women with septate uteri is improved after hysteroscopic septum insection.

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Diagnosis and treatment of oblique vaginal septum syndrome SUN Li-ying，ZHU Li 2018, 34(4): 374-377.  DOI: 10.19538/j.fk2018040107 Abstract ( )   Oblique vaginal septum syndrome（OVSS）is a rare type of clinical reproductive tract abnormality.A consensus has not been reached on its pathogeny，classification，diagnosis，and treatment in the international society.The diversity and complexity of clinical manifestations of OVSS increase the difficulty of diagnosis.The only one treatment for OVSS is surgery.The optimal time of operation is in menstruation.   Early detection，diagnosis and treatment are the key point in the prognosis.

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Diagnosis and treatment of MRKH syndrome LIU Yi-bin，YAN Lu 2018, 34(4): 377-381.  DOI: 10.19538/j.fk2018040108 Abstract ( )   The main symptoms of MRKH syndrome are primary amenorrhea and dyspareunia.For most sufferers，non-surgical treatment is the first-line treatment.If the patient does not receive non-surgical treatment or top pressure method fails，the vaginoplasty of various membranous lining or sigmoid colpoplasty may be selected.It has not been determined which vaginoplasty is the best choice.According to the patient’s situation，the medical technology and experience of the doctors，the long-term effects of postoperative vaginal function，appropriate operation should be selected.To avoid failure for the first time and to rebuild one that is most close to the normal morphology and function of the vagina is the principle and the goal.Medical-psycho-social therapy，long-term follow-up and help are necessary.Tissue engineering vaginoplasty may be the future direction of vaginal reconstruction.

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Surgical techniques of laparascopic peritoneal vaginoplasty（Luohu Ⅱ procedure） QIN Cheng-lu，ZHANG Di-kai 2018, 34(4): 381-385.  DOI: 10.19538/j.fk2018040109 Abstract ( )   laparascopic  peritoneal vaginoplasty（Luohu Ⅱ procedure）has showed to be a safe，simple and most efficient method of the treatment for MRKH syndrome  based on the 10 years’ successful experience in 1000 patients since 2001.laparascopic  peritoneal vaginoplasty（Luohu Ⅱ procedure）has shorter operation time，less blood loss and lower operation costs.Based on our experience  as well as the literature of vaginoplasty and the techniques of Luohu Ⅱ produces，indications，management principles，surgical skills and complications of  Luohu Ⅱ produces are introduced in this article.

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Surgical key points of laparoscopic vaginoplasty with intestine LIU Jian-hua，WANG Ping 2018, 34(4): 385-387.  DOI: 10.19538/j.fk2018040110 Abstract ( )   The intestine vaginoplasty（with sigmoid or ileum）can be finished under laparoscope.Compared with laparotomic procedure，laparoscopic intestine vaginoplasty should focus on the following aspects：（1）how to select the proper segment of sigmoid colon to meet the length and blood supply of neovagina；（2）in the preparation of sigmoid segment for neovagina，it's necessary to prevent the content of colon from polluting the peritoneal cavity and to avoid postoperative peritoneal infection；（3）a mini-incision should be made in lower abdominal wall for intestinal stapler to be used successfully，or intestinal stapler should be used by way of the artificial vaginal cave；（4）the preoperative intestinal preparation and the postoperative management are just as important to the success of vagionplasty.

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Advantages and disadvantages  of  different  vaginoplasty procedures LUO Guang-nan，QIN Cheng-lu 2018, 34(4): 387-392.  DOI: 10.19538/j.fk2018040111 Abstract ( )   Vaginoplasty  is an efficient treatment for patients with  absence of vagina.There are more then 20 kinds of  procedures of vaginoplasty in the past over 200 years.All procedures  have advantages and  disadvantages.An individualized vaginoplasty for the patients will bring them  good outcomes.

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Diagnosis and management of female ambiguous genitalia TIAN Qin-jie，LUO Min 2018, 34(4): 392-396.  DOI: 10.19538/j.fk2018040112 Abstract ( )   Ambiguous genitalia（AG）is related to abnormal effects of androgens.The major etiologies are congenital disorders of sex development（DSD）and acquired androgen secreting tumors.The key point of management is based on precise etiological diagnosis，and treatment methods include operations，drugs and plastic surgery.

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Diagnosis and treatment of genital anomalies in women with gonadal dysgenesis QIAN Hong-lang，ZHANG Xin-mei 2018, 34(4): 396-400.  DOI: 10.19538/j.fk2018040113 Abstract ( )   There are many subtypes of gonadal dysplasia，resulting in different clinical manifestations.Some patients have male manifestations of female genital organs.Early diagnosis and timely surgery are very important.The female orthopedic surgery for female genital organs includes clitoral plastic surgery and the plasty of labia and vagina.The choice of surgical modality and time should be individualized.Patients with Y chromosomes and abnormal testicular position should be treated with gonadectomy because they are prone to have gonadoblastoma and germ cell tumors.

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Fertility in patients with disorders of gonadal dysgenesis XU Yan-wen，HU Xiao-kun 2018, 34(4): 400-404.  DOI: 10.19538/j.fk2018040114 Abstract ( )   Gonadal dysgenesis is defined as congenital condition in which the development of gonadal sex is atypical.Modern medical techniques including hormone supplement therapy or surgery are very effective in promoting the development of internal and external genitalia，maintaining hormone balance and preventing tumor in gonadal dysgenesis patients.Fertility potential is one of the issues that should be considered when addressing management of individuals with gonadal dysgenesis.Although a majority of the gonadal dysgenesis patients suffer from infertility，assisted reproductive technology including oocyte donation and in vitro fertilization and embryo transfer could be helpful for them.Patients with gonadal dysgenesis could expect successful pregnancy and perinatal outcome by individualized treatments.This paper reviews the reproductive potential of gonadal dysgenesis patients and the progress in infertility treatment for them.