Abdel-Karim Aly M, Mousa Ahmed, Hasouna Mohamed, Elsalmy Salah
Urology Department, Alexandria University, 12 Ahmed Basha Zol-Fokar, # 903 Louran, Alexandria, Egypt.
Int Urogynecol J. 2011 Jun;22(6):693-7. doi: 10.1007/s00192-010-1334-7. Epub 2010 Nov 25.
Laparoscopic repair of vesicovaginal fistula (VVF) has been recently reported. We present our experience of laparoscopic transperitoneal extravesical repair of VVF.
Fifteen females with supratrigonal VVF were included. Patients with malignant radiation and recurrent fistulas were excluded. Laparoscopic transperitoneal extravesical repair was done using four to five ports. The bladder was closed longitudinally, while the vagina was closed transversally with interposition of omentum in between. Bladder was drained by a urethral catheter for 3 weeks.
Mean operative time was 171.6 ± 19.5 min. There was no conversion to open in all patients. Mean blood loss was 110 ± 17 cc. No intraoperative or postoperative complications. Mean hospital stay was 3 ± 1 days. At a mean follow-up of 18.9 ± 8.6 months all patients were cured.
Laparoscopic transperitoneal extravesical repair of VVF is a safe and effective minimally invasive procedure for treatment of VVF.
近期有报道称可通过腹腔镜修复膀胱阴道瘘（VVF）。我们在此介绍我们采用腹腔镜经腹膀胱外修复膀胱阴道瘘的经验。
纳入15例膀胱三角区上方膀胱阴道瘘的女性患者。排除因恶性肿瘤接受放疗及复发性瘘的患者。采用四至五个穿刺孔进行腹腔镜经腹膀胱外修复。膀胱纵向缝合，阴道横向缝合，中间置入大网膜。通过尿道导管对膀胱引流3周。
平均手术时间为171.6±19.5分钟。所有患者均未中转开腹。平均失血量为110±17毫升。无术中或术后并发症。平均住院时间为3±1天。平均随访18.9±8.6个月时，所有患者均治愈。
腹腔镜经腹膀胱外修复膀胱阴道瘘是一种治疗膀胱阴道瘘安全有效的微创手术。
