Lagundoye S B, Bell D, Gill G, Ogunbode O
Clin Radiol. 1976 Oct;27(4):531-39. doi: 10.1016/s0009-9260(76)80122-5.
Intravenous urographies carried out routinely on 216 cases of vesico-vaginal fistulae were reviewed. All the patients had suffered from urinary incontinence following obstructed labour for periods varying from immediate post-partum period to as long as 35 years with the majority (48%) presenting in the first year of the disease. One hundred and eleven patients (51-4%) showed no urinary tract abnormality. Calyceal abnormality was graded from 1-5 in ascending order of severity. The most frequent abnormality was Grade 1 (or minimal calyceal blunting) found in 75 (71%) of 105 cases showing lesions. Ten patients had non-functioning kidneys. There was no correlation of severity of calyceal grading with duration of the disease. Other notable changes were hydroureter in 75 (34%), medial deviation of the terminal ureters in 21 (9-7%) and bladder calculi in four. The study reveals a high risk of morbidity to the kidneys in patients with vesico-vaginal fistulae and the predominant role of fibrous itssue in tis genesis is postulated.
对216例膀胱阴道瘘患者常规进行的静脉尿路造影结果进行了回顾。所有患者均在分娩受阻后出现尿失禁，时间从产后即刻到长达35年不等，大多数患者（48%）在疾病的第一年出现症状。111例患者（51.4%）未发现尿路异常。肾盏异常按严重程度从1至5级进行分级。最常见的异常是1级（即轻度肾盏变钝），在105例有病变的病例中有75例（71%）出现。10例患者的肾脏无功能。肾盏分级的严重程度与疾病持续时间无相关性。其他显著变化包括75例（34%）出现输尿管积水，21例（9.7%）输尿管末端向内侧移位，4例出现膀胱结石。该研究揭示了膀胱阴道瘘患者肾脏发病的高风险，并推测纤维组织在其发病机制中起主要作用。
