Watanabe Miho, Yamanishi Tomonori, Kamai Takao, Huruya Nobutaka, Hukuda Takehiko, Yoshida Ken-Ichiro
The Department of Urology, Dokkyo University School of Medicine, Japan.
Hinyokika Kiyo. 2009 Nov;55(11):721-4.
A 45-year-old woman was admitted to our hospital with a chief complaint of stress urinary incontinence. She had undergone simple hysterectomy due to myoma uteri at another hospital. X-ray examination and ultrasonography revealed a hydronephrosis on the right side after the surgery, which was improved immediately without intervention. She was diagnosed as having stress incontinence according to the history, findings of frequency/volume chart, 1-hour pad test, cystoscopy, drip infusion pyelography, magnetic resonance imaging and so on. Periurethral injection with non-animal stabilized hyaluronic acid/ dextranomer was performed. Incontinence was improved, but was not cured completely. After indigo carmine intravenous injection, cystoscopy was performed but no urine flow was noted from the right ureteral orfice. At the transvesical investigation, blue fluid was found at the vagina, and she then was diagnosed as having right ureterovaginal fistula. She underwent ureterovaginal fistula repair and reimplantation of the right ureter, and her incontinence was cured. To our knowledge, this is the first case of ureterovaginal fistula associated with stress incontinence.
一名45岁女性因压力性尿失禁为主诉入院。她曾在另一家医院因子宫肌瘤接受了单纯子宫切除术。术后X线检查和超声检查发现右侧肾积水，未经干预积水立即改善。根据病史、频率/尿量图表结果、1小时尿垫试验、膀胱镜检查、静脉肾盂造影、磁共振成像等，她被诊断为压力性尿失禁。进行了非动物稳定化透明质酸/葡聚糖omer尿道周围注射。尿失禁有所改善，但未完全治愈。静脉注射靛胭脂后进行膀胱镜检查，未发现右侧输尿管口有尿液流出。在经膀胱检查时，发现阴道内有蓝色液体，随后她被诊断为右侧输尿管阴道瘘。她接受了输尿管阴道瘘修补术和右侧输尿管再植术，尿失禁得以治愈。据我们所知，这是首例与压力性尿失禁相关的输尿管阴道瘘病例。
