Gynatresia (English spelling)

Japanese: 鎖陰 - さいん（英語表記）Gynatresia
Gynatresia (English spelling)

What is the disease?

Semen ( Vaginal atresia ( Vagina ) ) is the aforementioned hymen closure Vaginal diaphragm ( Regional development ) , Vaginal stenosis ( Construction of the city ) It is a general term that includes.

During fetal development, solid Vaginal plate ( Second ) The vaginal plate hollows out to form the tubular structure of the vagina, but an obstruction occurs during the hollowing process, causing the vaginal canal to cross. Partition wall ( Concrete ) If the hollowing remains, the vaginal diaphragm will be formed, and if the hollowing is incomplete, vaginal stenosis will occur.

Vaginal diaphragm

As with the imperforate hymen, the first menstrual period during puberty causes problems with the discharge of menstrual blood, and Hemorrhage ( Ryukyu ) This leads to hematometra and hematosalpinx, and during puberty, women experience a condition known as menstrual ovulation, in which periodic abdominal pain occurs without menstrual blood.

If left untreated, it can cause infertility, so early colposcopic diaphragmectomy is performed.

Vaginal stenosis

There is no problem with menstrual discharge, but sexual intercourse is a problem. If the degree of stenosis is mild, a prosthesis (a tubular expansion device) is inserted, and gradually thicker prostheses are used to gradually expand the vagina, thereby expanding it. However, if the degree of stenosis is severe, surgery to create a vaginoplasty is required.

In any case, regular sexual intercourse and insertion of a prosthesis are necessary to maintain the dilated vagina, so unless you experience menstrual blood retention, it is advisable to begin treatment once you have a sexual partner.

Mikio Momoe

Source: Houken “Sixth Edition Family Medicine Encyclopedia” Information about the Sixth Edition Family Medicine Encyclopedia

Japanese:

どんな病気か

　鎖陰（腟閉鎖(ちつへいさ)）は、前述の処女膜閉鎖に腟横隔膜(ちつおうかくまく)、腟狭窄(ちつきょうさく)を加えた総称です。

　胎児発生の過程で、充実性の腟板(ちつばん)が空洞化して腟の管状構造が形成されますが、腟板の空洞化の過程で障害が生じ、腟管を横断する隔壁(かくへき)が残ると腟横隔膜が、また、その空洞化が不完全であると腟狭窄を来します。

●腟横隔膜

　処女膜閉鎖と同様に、思春期に月経が初来すると月経血の排出障害を来し、腟留血症(りゅうけつしょう)、子宮留血症、卵管留血症となり、思春期に月経血をみないまま周期的な腹痛が出現する月経モリミナという症状を示します。

　放置すれは不妊症の原因となるため、早期に腟横隔膜切除術を行います。

●腟狭窄

　月経血の排出障害はありませんが、性交障害が問題となります。狭窄の程度が軽度であれば、プロテーゼ（筒状の拡張器具）を挿入し、次第に太いプロテーゼを用いて徐々に拡張することで腟の拡張を図ります。しかし、狭窄の程度が強ければ手術により造腟術を行う必要があります。

　いずれにしても拡張した腟を維持するためには、定期的な性交渉やプロテーゼの挿入などが必要になるので、月経血の貯留を来さなければ、性交渉のパートナーが現れてから治療することが望まれます。

百枝　幹雄

出典　法研「六訂版 家庭医学大全科」六訂版 家庭医学大全科について　情報

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