Liu Brian J, Lee Patricia E
Department of Obstetrics & Gynaecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON.
Department of Obstetrics & Gynaecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON.
J Obstet Gynaecol Can. 2017 Nov;39(11):1038-1041. doi: 10.1016/j.jogc.2017.05.004. Epub 2017 Jul 18.
Prolapse can be treated with expectant management, pessary, or surgery. Although we consider the first two options benign, rare but serious complications can arise. CASE 1: A 64-year-old presented with recurrent grade 4 prolapse. After 6 months of expectant management, she developed a fistula from an ulcerated area of the prolapse into the peritoneal cavity. CASE 2: An 81-year-old who diligently cared for her ring pessary for 18 years presented with a vesicovaginal fistula. CASE 3: An 80-year-old with a longstanding pessary who stopped using vaginal estrogen for 2 years before developing a vesicovaginal fistula.
Management of prolapse expectantly and with pessaries are effective treatments, especially to avoid surgery, but can present with their own unusual and infrequent complications, such as fistula formation.
子宫脱垂可采用期待治疗、子宫托或手术治疗。虽然我们认为前两种选择是良性的，但可能会出现罕见但严重的并发症。病例1：一名64岁女性出现复发性4级脱垂。经过6个月的期待治疗后，她出现了一个瘘管，从脱垂的溃疡部位通向腹腔。病例2：一名81岁女性，她认真护理环形子宫托18年，出现了膀胱阴道瘘。病例3：一名80岁女性，长期使用子宫托，在出现膀胱阴道瘘前2年停用了阴道雌激素。
子宫脱垂的期待治疗和使用子宫托是有效的治疗方法，尤其是为了避免手术，但可能会出现其自身不常见和罕见的并发症，如瘘管形成。
