Tasdemir Nicel, Abali Remzi, Celik Cem, Yazici Cenk Murat, Akkus Didem
1 Namik Kemal University Faculty of Medicine, Department of Obstetrics and Gynecology, Tekirdag, Turkey.
Int Surg. 2014 Sep-Oct;99(5):673-6. doi: 10.9738/INTSURG-D-13-00148.1.
Vesicouterine fistula (VUF) is a rare type of genitourinary fistula. Lower-segment cesarean section is the leading cause of VUF. Patients mostly present with the classical triad of menouria, amenorrhea, and urinary incontinence, with the history of a previous cesarean section. Conservative management with catheterization and open, laparoscopic, and robotic surgeries are the prescribed treatment options. We present the case of a 35-year-old woman who presented with cyclical menouria and urinary incontinence. After diagnosis of VUF by cystoscopy, the laparoscopic approach was chosen. During the procedure, we used anterior abdominal wall peritoneum and adjacent adipose tissue interposition for the first time, instead of omental interposition, because of the unavailability of omentum. The postoperative period was uneventful, and the procedure was successful. In conclusion, the laparoscopic approach is feasible and the anterior abdominal wall peritoneal flap can be used instead of omentum for tissue interposition when the omentum is not available.
膀胱子宫瘘（VUF）是一种罕见的泌尿生殖瘘。下段剖宫产是VUF的主要病因。患者大多表现为典型的三联征，即月经性血尿、闭经和尿失禁，且有既往剖宫产史。规定的治疗选择包括导管插入术的保守治疗以及开放手术、腹腔镜手术和机器人手术。我们报告一例35岁女性，她表现为周期性月经性血尿和尿失禁。经膀胱镜检查诊断为VUF后，选择了腹腔镜手术方法。在手术过程中，由于无法获得大网膜，我们首次使用前腹壁腹膜和相邻脂肪组织进行置入，而不是大网膜置入。术后恢复顺利，手术成功。总之，腹腔镜手术方法是可行的，当无法获得大网膜时，前腹壁腹膜瓣可用于替代大网膜进行组织置入。
