Hadzi-Djokic Jovan B, Pejcic Tomislav P, Colovic Vidosav C
Clinical Centre of Serbia, Urological Clinic and the Hospital Centre Bezanijska Kosa, Department of Urology, Belgrade, Serbia.
BJU Int. 2007 Dec;100(6):1361-3. doi: 10.1111/j.1464-410X.2007.07067.x. Epub 2007 Jun 21.
To analyse the indications, diagnosis, major causes and basic principles of surgical treatment of vesico-uterine fistulas (VUF).
From 1970 to 2006, 14 patients underwent surgical repair of VUF in two Belgrade hospitals. The most common cause of a fistula was previous Caesarean section (13/14). The mean (range) age was 27 (22-38) years. Five women underwent transvesical fistula suture, and nine underwent a transperitoneal surgical approach with the interposition of a tissue flap; an omental flap in five and a peritoneal flap in four.
The mean (range) duration of surgery was 85 (70-120) min. The mean hospital stay was 14 (12-22) days. The urethral catheter was removed 10 days after surgery. One woman with no tissue flap repair relapsed and none of the women with a tissue flap repair relapsed. After surgery, eight patients became pregnant and underwent Caesarean section.
Successful closure of VUF requires accurate diagnostic evaluation, appropriate repair using techniques that utilize basic surgical principles, and the careful application of interposing tissue flaps.
分析膀胱子宫瘘（VUF）的手术治疗指征、诊断、主要病因及基本原则。
1970年至2006年期间，贝尔格莱德的两家医院有14例患者接受了VUF手术修复。瘘管最常见的病因是既往剖宫产（13/14）。平均（范围）年龄为27（22 - 38）岁。5例女性接受了经膀胱瘘管缝合，9例接受了经腹手术并置入组织瓣；其中5例置入网膜瓣，4例置入腹膜瓣。
平均（范围）手术时间为85（70 - 120）分钟。平均住院时间为14（12 - 22）天。术后10天拔除尿道导管。1例未进行组织瓣修复的女性复发，而所有进行组织瓣修复的女性均未复发。术后，8例患者怀孕并接受了剖宫产。
成功闭合VUF需要准确的诊断评估，采用运用基本外科原则的技术进行适当修复，并谨慎应用置入组织瓣。
