McKay H A
Valley Medical Center, Renton, Washington, USA.
Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(4):282-7. doi: 10.1007/s001920170054.
Technical difficulties in the initially described transurethral repair of vesicovaginal fistulas have led to several modifications in technique. In an uncontrolled trial, these modifications included the use of a suprapubic tract, along with an arthroscope for visualization of the fistula. A large-caliber port is passed per urethram for transurethral instrumentation access. New-generation laparoscopic needle driver technology markedly improves the ease of transurethral suturing. Three previously unreported vesicovaginal fistula patients have had successful resolution of their fistulas after undergoing transurethral repair. Small-diameter vesicovaginal fistulas in selected patients can be successfully repaired by a minimally invasive transurethral suture technique.
最初描述的经尿道膀胱阴道瘘修补术存在技术难题，促使人们对技术进行了多项改进。在一项非对照试验中，这些改进包括采用耻骨上通道，以及使用关节镜来观察瘘管。通过尿道置入一个大口径端口，以便经尿道进行器械操作。新一代腹腔镜持针器技术显著提高了经尿道缝合的便利性。3例先前未报道过的膀胱阴道瘘患者在接受经尿道修补术后，瘘管成功愈合。对于部分选定患者的小直径膀胱阴道瘘，可通过微创经尿道缝合技术成功修复。
