Cardenas-Trowers Olivia, Heusinkveld John, Hatch Kenneth
Department of Obstetrics and Gynecology, University of Arizona, 1501 North Campbell Avenue, PO Box 245078, Tucson, AZ, 85724, USA.
Int Urogynecol J. 2018 May;29(5):767-769. doi: 10.1007/s00192-017-3471-8. Epub 2017 Sep 7.
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.
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.
The patient had successful surgical correction of her vesico-vaginal fistula without recurrence of the fistula.
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.
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。
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。
患者的膀胱阴道瘘手术矫正成功,瘘管未复发。
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。