Jóźwik M, Jóźwik M
Department of Gynecology, Institute of Obstetrics and Gynecology, Bialystok Medical University, Bialystok, Poland.
Urol Int. 1999;62(3):183-7. doi: 10.1159/000030388.
To analyze the incidence of spontaneous closure, or non-surgical resolution, of vesicouterine fistula and discuss the resultant implications for the management.
Review of the literature supplemented by case report of a young woman with spontaneous healing of vesicouterine fistula.
This is the 41st patient with spontaneous closure of vesicouterine fistula reported to date. Her clinical course was suggestive of endocrine involvement in the lesion's formation. Spontaneous healing was observed in 5% of 796 vesicouterine fistula cases. Induction of amenorrhea was effective in 8 (89%) of the 9 patients treated, a rate significantly higher (p < 0.001) than that observed without hormonal manipulation (4%).
Conservative management by means of hormonal treatment should be considered before surgical repair. We suggest the role of estrogens and the endometrium in the formation of vesicouterine fistulas.
分析膀胱子宫瘘自然闭合或非手术治愈的发生率，并探讨其对治疗的影响。
通过文献回顾，并补充一名膀胱子宫瘘自然愈合的年轻女性病例报告。
这是迄今为止报道的第41例膀胱子宫瘘自然闭合患者。她的临床病程提示内分泌因素参与了病变的形成。在796例膀胱子宫瘘病例中，5%观察到自然愈合。在接受治疗的9例患者中，8例（89%）闭经诱导有效，该比率显著高于未进行激素干预时观察到的比率（4%）（p<0.001）。
在进行手术修复前，应考虑通过激素治疗进行保守管理。我们提出雌激素和子宫内膜在膀胱子宫瘘形成中的作用。
