Objective: This study was undertaken to evaluate structural and ultrastructural characteristics of the mucosa of neovaginae created by Vecchietti’s laparoscopic operation for Rokitansky syndrome. Study design: Vagino...Objective: This study was undertaken to evaluate structural and ultrastructural characteristics of the mucosa of neovaginae created by Vecchietti’s laparoscopic operation for Rokitansky syndrome. Study design: Vaginoscopy and Schiller test were performed 3, 6, and 12 months after the operation in 106 patients. A biopsy specimen of the neovagina obtained 12 to 18 months after surgery in 19 patients was examined by light, scanning electron, and transmission electron microscopy. Results: At vaginoscopy, the neovaginal mucosa appeared smooth, lacking the folds that characterize the normal vagina; 12 months after the operation, an iodium-positive epithelium was present in all neovaginae. Mild ultrastructural modifications, as compared with normal vaginal mucosa, were reduced maturation, inflammatory infiltration, and tendency to superficial desquamation. Conclusion: At a 12-month follow-up, the mucosa of neovaginae created by the Vecchietti technique is comparable to the normal vaginal mucosa, with mild structural and ultrastructural modifications that we believe might be due to reduced vascularization.展开更多
Mayer Rokitansky Küster Hauser (MRKH) syndrome is a rare congenital disorder that occurs during foetal development. MRKH is characterised by agenesis of the uterus and part of the vagina. Its exact aetiology is s...Mayer Rokitansky Küster Hauser (MRKH) syndrome is a rare congenital disorder that occurs during foetal development. MRKH is characterised by agenesis of the uterus and part of the vagina. Its exact aetiology is still unknown due to the complexity of the genetic pathways involved in the embryogenetic development of the Müllerian ducts. Although these women have a female phenotype and functional ovaries, they do not have menstrual cycles. We report the rare case of a 23-year-old married woman who consulted us for primary amenorrhoea and desire for pregnancy. On assessment and investigation, it was confirmed that the patient had no uterus and a poorly developed vagina. However, she had normal functioning ovaries, and no abnormalities in other organs were detected. A multidisciplinary team provided advice on the nature of the anomaly, its implications for sex life, infertility and possible child adoption alternatives.展开更多
Esophageal diverticula are rare conditions that cause esophageal symptoms,such as dysphagia,regurgitation,and chest pain.They are classified according to their location and characteristic pathophysiology into three ty...Esophageal diverticula are rare conditions that cause esophageal symptoms,such as dysphagia,regurgitation,and chest pain.They are classified according to their location and characteristic pathophysiology into three types:epiphrenic diverticulum,Zenker's diverticulum,and Rokitansky diverticulum.The former two disorders take the form of protrusions,and symptomatic cases require interventional treatment.However,the esophageal anatomy presents distinct challenges to surgical resection of the diverticulum,particularly when it is located closer to the oral orifice.Since the condition itself is not malignant,minimally invasive endoscopic approaches have been developed with a focus on alleviation of symptoms.Several types of endoscopic devices and techniques are currently employed,including peroral endoscopic myotomy(POEM).However,the use of minimally invasive endoscopic approaches,like POEM,has allowed the development of new disorder called iatrogenic esophageal diverticula.In this paper,we review the pathophysiology of each type of diverticulum and the current state-of-the-art treatment based on our experience.展开更多
文摘Objective: This study was undertaken to evaluate structural and ultrastructural characteristics of the mucosa of neovaginae created by Vecchietti’s laparoscopic operation for Rokitansky syndrome. Study design: Vaginoscopy and Schiller test were performed 3, 6, and 12 months after the operation in 106 patients. A biopsy specimen of the neovagina obtained 12 to 18 months after surgery in 19 patients was examined by light, scanning electron, and transmission electron microscopy. Results: At vaginoscopy, the neovaginal mucosa appeared smooth, lacking the folds that characterize the normal vagina; 12 months after the operation, an iodium-positive epithelium was present in all neovaginae. Mild ultrastructural modifications, as compared with normal vaginal mucosa, were reduced maturation, inflammatory infiltration, and tendency to superficial desquamation. Conclusion: At a 12-month follow-up, the mucosa of neovaginae created by the Vecchietti technique is comparable to the normal vaginal mucosa, with mild structural and ultrastructural modifications that we believe might be due to reduced vascularization.
文摘Mayer Rokitansky Küster Hauser (MRKH) syndrome is a rare congenital disorder that occurs during foetal development. MRKH is characterised by agenesis of the uterus and part of the vagina. Its exact aetiology is still unknown due to the complexity of the genetic pathways involved in the embryogenetic development of the Müllerian ducts. Although these women have a female phenotype and functional ovaries, they do not have menstrual cycles. We report the rare case of a 23-year-old married woman who consulted us for primary amenorrhoea and desire for pregnancy. On assessment and investigation, it was confirmed that the patient had no uterus and a poorly developed vagina. However, she had normal functioning ovaries, and no abnormalities in other organs were detected. A multidisciplinary team provided advice on the nature of the anomaly, its implications for sex life, infertility and possible child adoption alternatives.
文摘Esophageal diverticula are rare conditions that cause esophageal symptoms,such as dysphagia,regurgitation,and chest pain.They are classified according to their location and characteristic pathophysiology into three types:epiphrenic diverticulum,Zenker's diverticulum,and Rokitansky diverticulum.The former two disorders take the form of protrusions,and symptomatic cases require interventional treatment.However,the esophageal anatomy presents distinct challenges to surgical resection of the diverticulum,particularly when it is located closer to the oral orifice.Since the condition itself is not malignant,minimally invasive endoscopic approaches have been developed with a focus on alleviation of symptoms.Several types of endoscopic devices and techniques are currently employed,including peroral endoscopic myotomy(POEM).However,the use of minimally invasive endoscopic approaches,like POEM,has allowed the development of new disorder called iatrogenic esophageal diverticula.In this paper,we review the pathophysiology of each type of diverticulum and the current state-of-the-art treatment based on our experience.
