Fridman Dmitry, Chakraborty Shamik, Khulpateea Neekianund
Department of Obstetrics and Gynecology, Maimonides Medical Center, 950 49th street apt 9J, Brooklyn, New York, NY, USA.
Int Urogynecol J. 2011 Oct;22(10):1329-31. doi: 10.1007/s00192-011-1414-3. Epub 2011 Mar 31.
Most common reason for the vesicouterine fistula is a cesarean section; no cases were reported of degenerated uterine leiomyoma communicating with the urinary bladder. We report a case of fistulous communication between the degenerated leiomyoma and the bladder. The patient's initial clinical presentation was consistent with recurrent UTI. She underwent multiple examinations including cystoscopy, cystouretrography, retrograde pyeolography, and MRI. The ultimate treatment was an exploratory laparotomy and en-block resection of the bladder wall, fistula tract, and degenerated leiomyoma. Fistula can develop between the bladder and degenerated leiomyoma and could be one of the reasons for the chronic pelvic pain and dysuria.
膀胱子宫瘘最常见的原因是剖宫产；未报告有退化的子宫平滑肌瘤与膀胱相通的病例。我们报告一例退化的平滑肌瘤与膀胱之间形成瘘管相通的病例。患者最初的临床表现与复发性尿路感染相符。她接受了包括膀胱镜检查、膀胱尿道造影、逆行肾盂造影和磁共振成像在内的多项检查。最终的治疗方法是进行剖腹探查，并整块切除膀胱壁、瘘管和退化的平滑肌瘤。瘘管可在膀胱与退化的平滑肌瘤之间形成，可能是慢性盆腔疼痛和排尿困难的原因之一。
