Novi Joseph M, Rose Marisa, Shaunik Alka, Ramchandani Parvati, Morgan Mark A
Department of Obstetrics and Gynecology, University of Pennsylvania, 5 Penn Tower, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Int Urogynecol J Pelvic Floor Dysfunct. 2004 Nov-Dec;15(6):434-5. doi: 10.1007/s00192-004-1165-5. Epub 2004 Jun 12.
We report the closure of a vesicouterine fistula with conservative management utilizing an indwelling transurethral Foley catheter. Uterine rupture occurred during a trial of vaginal birth after cesarean section, necessitating an emergency cesarean section. Upon entry into the abdomen, the base of the bladder was noted to be involved in the uterine rupture. The bladder trigone and ureteral orifices appeared normal. A primary, two-layer bladder repair was performed. A cystogram on postoperative day 14 demonstrated a vesicouterine fistula. Conservative management involving bladder drainage for 21 days with a transurethral Foley catheter was successful in closure of the fistula. Vesicouterine fistula, a documented complication of uterine rupture due to attempted vaginal birth after previous cesarean section, can spontaneously resolve with conservative management alone.
我们报告了一例采用留置经尿道Foley导管进行保守治疗成功闭合膀胱子宫瘘的病例。剖宫产术后试产期间发生子宫破裂，需行急诊剖宫产术。进入腹腔后，发现膀胱底部与子宫破裂处相连。膀胱三角区和输尿管口外观正常。进行了一期两层膀胱修补术。术后第14天的膀胱造影显示存在膀胱子宫瘘。采用经尿道Foley导管对膀胱进行21天引流的保守治疗成功闭合了瘘管。膀胱子宫瘘是既往剖宫产术后试产导致子宫破裂的一种已记录的并发症，仅通过保守治疗即可自发愈合。
