Kochakarn W, Ratana-Olarn K, Viseshsindh V, Muangman V, Gojaseni P
Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
J Med Assoc Thai. 2000 Oct;83(10):1129-32.
We reviewed 230 cases of vesico-vaginal fistula in Ramathibodi Hospital from 1969 to 1997. The cases of fistula included 164 cases after transabdominal hysterectomies, 5 cases after anterior colporrhaphies, 8 cases after radical hysterectomy, 23 cases after vaginal hysterectomy, 10 cases after prolonged or traumatic birth, 9 cases after radiation for cervical carcinoma, 7 cases of cervical cancer invasion, 2 cases after suprapubic cystolithotomy and 2 cases after pelvic fracture. Most of them were referred from other hospitals. In 7 cases, the fistula closed spontaneously after indwelling urethral catheters for 4-6 weeks. Five cases were cured after transurethral fulgurations. The rest were treated with different surgical procedures i.e. transvaginal, transvesical and retrovesical repairs. Ten cases were treated by urinary diversions, usually after failure using other surgical procedures.
我们回顾了1969年至1997年拉玛蒂博迪医院收治的230例膀胱阴道瘘病例。瘘管病例包括经腹子宫切除术后164例、前阴道壁修补术后5例、根治性子宫切除术后8例、经阴道子宫切除术后23例、分娩延长或产伤后10例、宫颈癌放疗后9例、宫颈癌侵犯7例、耻骨上膀胱切开取石术后2例以及骨盆骨折后2例。大多数病例是从其他医院转诊而来。7例患者在留置尿道导管4 - 6周后瘘管自行闭合。5例经尿道电灼术后治愈。其余患者采用不同的外科手术治疗，即经阴道、经膀胱和膀胱后修补术。10例患者通常在其他手术方法失败后接受尿流改道术。
