James Rebecca, Mahajan Sangeeta Tina
MacDonald Women's Hospital, University Hospitals Case Medical Center, Cleveland, OH, USA.
Int Urogynecol J. 2013 Jan;24(1):173-4. doi: 10.1007/s00192-011-1623-9. Epub 2011 Dec 6.
Although rare in the USA, vesicovaginal fistulae are usually associated with postoperative complications. Even more rarely seen, vesicoperitoneal fistulae can also present postoperatively. Both types of fistulae pose as diagnostically challenging and can be difficult to manage. We describe a case report of a patient with both vesicovaginal and vesicoperitoneal fistulae after a laparoscopic-assisted vaginal hysterectomy who presented with abdominal pain and anuria. Cystogram and outpatient cystoscopy were imperative in the diagnosis. She was conservatively managed with continuous bladder drainage via indwelling catheter resulting in an ideal recovery without requiring reoperation.
在美国，膀胱阴道瘘虽然罕见，但通常与术后并发症相关。膀胱腹膜瘘更为罕见，也可在术后出现。这两种类型的瘘都具有诊断挑战性，且难以处理。我们报告一例患者，在腹腔镜辅助下阴道子宫切除术后出现膀胱阴道瘘和膀胱腹膜瘘，表现为腹痛和无尿。膀胱造影和门诊膀胱镜检查对诊断至关重要。通过留置导管持续膀胱引流对她进行保守治疗，使其理想康复，无需再次手术。
