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简单有效:采用改良Latzko技术经阴道修复膀胱阴道瘘

Simple and effective: transvaginal vesico-vaginal fistula repair with a modified Latzko technique.

作者信息

Cardenas-Trowers Olivia, Heusinkveld John, Hatch Kenneth

机构信息

Department of Obstetrics and Gynecology, University of Arizona, 1501 North Campbell Avenue, PO Box 245078, Tucson, AZ, 85724, USA.

出版信息

Int Urogynecol J. 2018 May;29(5):767-769. doi: 10.1007/s00192-017-3471-8. Epub 2017 Sep 7.

Abstract

INTRODUCTION AND HYPOTHESIS

The incidence of vesico-vaginal fistulas after hysterectomies for benign indications in developed countries is less than one percent. The objective of this video is to demonstrate an easy-to-follow, step-by-step approach to repairing a small, uncomplicated vesico-vaginal fistula transvaginally using a modified Latzko technique.

METHODS

In this video, we present a case of a 46-year-old woman who developed a simple, uncomplicated vesico-vaginal fistula after a total abdominal hysterectomy. To correct her fistula, we used a modified Latzko technique, which is a transvaginal approach to vesico-vaginal fistula repair that involves mobilizing the vaginal mucosa around the fistula and then closing the pubo-vesical fascia and vaginal mucosa in layers.

RESULTS

The patient had successful surgical correction of her vesico-vaginal fistula without recurrence of the fistula.

CONCLUSIONS

For small, uncomplicated vesico-vaginal fistulas, a transvaginal approach has an equivalent success rate to that of other approaches with less invasiveness and faster recovery times. Therefore, it is reasonable to use a modified Latzko technique to help restore the quality of life to women affected by small, uncomplicated vesico-vaginal fistulas.

摘要

引言与假设

在发达国家,因良性指征行子宫切除术后发生膀胱阴道瘘的发生率低于1%。本视频的目的是展示一种易于遵循的、逐步的经阴道使用改良Latzko技术修复小的、不复杂的膀胱阴道瘘的方法。

方法

在本视频中,我们展示了一例46岁女性患者,她在全腹子宫切除术后发生了简单的、不复杂的膀胱阴道瘘。为修复她的瘘管,我们使用了改良Latzko技术,这是一种经阴道修复膀胱阴道瘘的方法,包括游离瘘管周围的阴道黏膜,然后分层缝合耻骨膀胱筋膜和阴道黏膜。

结果

患者的膀胱阴道瘘手术矫正成功,瘘管未复发。

结论

对于小的、不复杂的膀胱阴道瘘,经阴道手术方法与其他方法成功率相当,但具有创伤小、恢复快的特点。因此,使用改良Latzko技术帮助受小的、不复杂的膀胱阴道瘘影响的女性恢复生活质量是合理的。

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