Sylla C, Fall P A, Diallo A B, Ndoye A K, Ba M, Gueye S M, Diagne B A
Service d'Urologie-Andrologie, CHU Aristide Le Dantec, Dakar, Sénégal.
Prog Urol. 2000 Sep;10(4):634-7.
The authors report 5 cases of uterovesical fistula (UVF) and analyse some of the clinical and therapeutic aspects of this disease. The mean age of these 5 patients was 31.2 +/- 6.9 years. The trauma responsible for the fistula was caesarean section in every case. The presenting complaints were dominated by cyclic haematuria (n = 5). Intravenous urography did not contribute to the diagnosis, while hysterosalpingography demonstrated the UVF in 3 out of 4 cases. Treatment was surgical for all patients and consisted of closure of the fistula in 3 cases and hysterectomy in 2 cases. With a mean follow-up of 2 +/- 1.2 years, no pregnancies were reported in the 3 patients treated by closure of the fistula. On the other hand, the urinary results were satisfactory with good continence and resolution of the cyclic haematuria. The authors emphasize the importance of prevention of UVF by well conducted caesarean section.
作者报告了5例膀胱子宫瘘(UVF)病例,并分析了该疾病的一些临床和治疗方面。这5例患者的平均年龄为31.2±6.9岁。导致瘘管形成的创伤均为剖宫产。主要症状以周期性血尿为主(n = 5)。静脉肾盂造影对诊断无帮助,而子宫输卵管造影在4例中有3例显示出膀胱子宫瘘。所有患者均接受手术治疗,3例行瘘管闭合术,2例行子宫切除术。平均随访2±1.2年,3例接受瘘管闭合术治疗的患者均未报告怀孕。另一方面,排尿结果令人满意,尿失禁情况良好,周期性血尿消失。作者强调通过规范实施剖宫产预防膀胱子宫瘘的重要性。