Yang Bo
Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Zhongshan Road 467, Shahekou District, Dalian, Liaoning Province 116027, China.
Int Urogynecol J. 2011 May;22(5):625-7. doi: 10.1007/s00192-010-1318-7. Epub 2010 Nov 25.
This paper seeks to study the clinical presentation and emergency treatment of bladder rupture associated with uterine rupture at delivery. From June to December 2009, three cases of rupture of the uterus involving maternal bladder during labor at Revolutionary Hospital at Hodeidah, Yemen were reviewed. Intraoperatively, it appeared that the posterior wall of the bladder and the anterior wall of the uterus had ruptured; the laceration of the posterior bladder wall was closed in two layers. Of the patients who underwent the operations, one patient developed vesicovaginal fistula, which was repaired vaginally after 6 months, and the patient had a successful outcome. The others got uneventful recovery and there was no vesicovaginal fistula or hydronephrosis during follow-up. Uterine rupture and associated injury to the maternal bladder was rarely reported. It would be life threatening or would lead to long-term complications. Both urologists and obstetrician should keep bladder injuries in mind, as serious outcomes might occur during labor. Surgical treatment could be the preferred approach for this situation.
本文旨在研究分娩时子宫破裂合并膀胱破裂的临床表现及急诊治疗。回顾了2009年6月至12月也门荷台达革命医院分娩时发生子宫破裂累及产妇膀胱的3例病例。术中发现膀胱后壁和子宫前壁破裂;膀胱后壁裂伤分两层缝合。接受手术的患者中,1例发生膀胱阴道瘘,6个月后经阴道修复,患者预后良好。其他患者恢复顺利,随访期间未发生膀胱阴道瘘或肾积水。子宫破裂合并产妇膀胱损伤的报道很少。这可能会危及生命或导致长期并发症。泌尿外科医生和产科医生都应牢记膀胱损伤,因为分娩时可能会出现严重后果。手术治疗可能是这种情况的首选方法。