{"created":"2023-05-25T05:26:47.535658+00:00","id":5713,"links":{},"metadata":{"_buckets":{"deposit":"e958e777-19bd-45b2-9156-68d53e4504e5"},"_deposit":{"created_by":17,"id":"5713","owners":[17],"pid":{"revision_id":0,"type":"depid","value":"5713"},"status":"published"},"_oai":{"id":"oai:yamagata.repo.nii.ac.jp:00005713","sets":["29:31:482:483"]},"author_link":["17095","17096","17097","17098","17099","17100","17101","17102","17103","17104","17151","17105","17106","17107","17108","17109","17110","17111"],"control_number":"5713","item_3_alternative_title_18":{"attribute_name":"その他の言語のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Pregnancy and term delivery after vagino plasty using oxidized regenerated cellulose membrane in a patient with congenital lower vaginal defect"}]},"item_3_alternative_title_19":{"attribute_name":"タイトル（ヨミ）","attribute_value_mlt":[{"subitem_alternative_title":"サンカ サイセイ サイセルロースマク オ モチイタ ゾウチツジュツ ゴ ニ ニンシン シュッサン シタ センテンセイ チツブ ケッソンショウ ノ イチレイ","subitem_alternative_title_language":"ja-Kana"}]},"item_3_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2023-02-15","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"22","bibliographicPageStart":"17","bibliographicVolumeNumber":"41","bibliographic_titles":[{"bibliographic_title":"山形大学紀要. 医学 : 山形医学"},{"bibliographic_title":"Bulletin of the Yamagata University. Medical science : Yamagata medical journal","bibliographic_titleLang":"en"}]}]},"item_3_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"論文(Article)","subitem_description_type":"Other"}]},"item_3_description_5":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"先天性腟下部欠損症は造腟術が主な治療であるが、術後の再狭窄や性交障害例が多く、分娩まで至った報告は少数である。今回、酸化再生セルロース膜を用いた造腟術施行後に、妊娠・分娩まで至った先天性腟下部欠損症を経験したので報告する。17歳、未妊。14歳より周期的な下腹部痛を自覚し、月経がなく近医受診。診察上小陰唇が癒合し腟口を認めず、精査目的に当科紹介。MRI検査では腟下部2/3は索状の瘢痕で、右卵巣の腫大を認め、先天性腟下部欠損症による月経モリミナ、右卵巣チョコレート嚢胞と診断し、腹腔鏡下造腟術と内膜症病変焼灼術を施行し、術後LEP製剤を開始した。22歳時に性交障害を認め、受診した。腟口の再狭窄と卵巣チョコレート嚢胞再発の診断で、２回目の造腟術と腹腔鏡下内膜症病変焼灼術を施行した。術後は腟口の狭窄予防に、酸化再生セルロース膜を被覆した腟拡張器の自己挿入を指導した。その後性交は可能だったが妊娠せず、23歳時に不妊外来受診した。採血上、卵巣機能低下を認めた。人工授精で妊娠せず、顕微受精後に妊娠した。腟口狭窄のため、経腟分娩は困難と判断し帝王切開術とした。産後６か月でLEP製剤を開始し現在明らかな子宮内貯留は認めていない。今回、月経モリミナや子宮内膜症を有する先天性腟下部欠損症に対して造腟術を施行し、術後の腟再狭窄予防目的に酸化再生セルロース膜を被覆した腟拡張器を装着した結果、妊娠、分娩まで至った症例を経験した。将来的な妊娠や出産を見据えて、造腟後の狭窄、内膜症や手術に伴う妊孕性の低下をモニタリングする長期的な管理が重要と考えた。","subitem_description_type":"Other"}]},"item_3_full_name_2":{"attribute_name":"著者(ヨミ)","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"17101","nameIdentifierScheme":"WEKO"}],"names":[{"name":"カワナミ, 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