Bettez Mathieu, Breault Guy, Carr Lesley, Tu Le Mai
The Urology Division, Department of Surgery, University of Sherbrooke, Sherbrooke, QC;
Can Urol Assoc J. 2011 Aug;5(4):E52-5. doi: 10.5489/cuaj.10065.
Vesicouterine fistulas (VUF) are a pathological and uncommon connection between the uterus and the bladder. Although rare, they are usually related to cesarean section. Nowadays, their incidence increases because of the increase in Cesarean sections. Patients with VUF may have various clinical presentations. The main symptoms are urinary incontinence, which may be associated with hematuria. Vesicouterine fistulas are usually associated with psychological distress and have a negative effect on quality of life. The accurate and early diagnosis of VUF can be difficult. There are multiple ways to investigate VUF and several examinations may be required to confirm the diagnosis; these examinations may include a cystoscopy, a retrograde cystography, methylene blue test and a computed tomography scan. We present 3 cases of vesicouterine fistula with successful surgical repair in which 2 patients had an early repair. One patient had an early surgical repair because of intractable pain and the other patient because of the large size of the fistula. The fistula repair surgeries were uneventful and the patients had an unremarkable recovery. We report that early surgical management is technically feasible without significantly increasing the difficulty of the surgery, with an excellent outcome in selected patients.
膀胱子宫瘘（VUF）是子宫与膀胱之间一种病理性且不常见的连接。尽管罕见，但它们通常与剖宫产有关。如今，由于剖宫产数量的增加，其发病率有所上升。VUF患者可能有多种临床表现。主要症状是尿失禁，可能伴有血尿。膀胱子宫瘘通常会导致心理困扰，对生活质量产生负面影响。VUF的准确早期诊断可能具有挑战性。有多种方法可用于检查VUF，可能需要多项检查来确诊；这些检查可能包括膀胱镜检查、逆行膀胱造影、亚甲蓝试验和计算机断层扫描。我们报告了3例成功进行手术修复的膀胱子宫瘘病例，其中2例患者进行了早期修复。1例患者因顽固性疼痛进行了早期手术修复，另1例患者因瘘口较大进行了早期手术修复。瘘口修复手术顺利，患者恢复良好。我们报告早期手术治疗在技术上是可行的，不会显著增加手术难度，在特定患者中效果良好。
