Milani Rodolfo, Cola Alice, Frigerio Matteo, Manodoro Stefano
Department of Obstetrics and Gynaecology, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, Monza, MB, Italy.
Int Urogynecol J. 2018 Feb;29(2):309-311. doi: 10.1007/s00192-017-3506-1. Epub 2017 Nov 16.
Vesicouterine fistula is a rare complication of cesarean section. The aim of this video is to present a case report and to provide a tutorial on the surgical technique of delayed transvaginal repair of a high vesicouterine fistula that developed after cesarean section with manual removal of a morbidly adherent placenta.
A 43-year-old woman was referred to our unit for continuous urinary leakage 3 months after undergoing a cesarean section with manual removal of a morbidly adherent placenta. A vesicouterine fistula starting from the posterior bladder wall was identified. The surgical repair consisted of a transvaginal layered repair as shown in the video.
No surgical complications were observed postoperatively. Two months after surgery the fistula had not recurred and the patient reported no urinary leakage.
Transvaginal layered primary repair of vesicouterine fistula was shown to be a safe and effective procedure for restoring continence. The vaginal route can be particularly attractive for urogynecological surgeons.
膀胱子宫瘘是剖宫产罕见的并发症。本视频的目的是展示一例病例报告，并提供关于剖宫产术中人工剥离植入性胎盘后发生的高位膀胱子宫瘘延迟经阴道修复手术技术的教程。
一名43岁女性在剖宫产术中人工剥离植入性胎盘3个月后因持续性尿漏转诊至我院。发现一个起自膀胱后壁的膀胱子宫瘘。手术修复如视频所示采用经阴道分层修复。
术后未观察到手术并发症。术后两个月，瘘未复发，患者报告无尿漏。
经阴道分层一期修复膀胱子宫瘘被证明是恢复控尿的安全有效方法。经阴道途径对泌尿妇科医生可能特别有吸引力。
