Lee Dominic, Zimmern Philippe
Department of Urology, St George Hospital, 28A Gray Street, Kogarah, New South Wales 2217, Australia.
Department of Urology, UT Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, JA5- 130 C, Dallas, TX 75390-9110, USA.
Urol Clin North Am. 2019 Feb;46(1):123-133. doi: 10.1016/j.ucl.2018.08.010.
Vesicovaginal fistula is the most commonly encountered sequela of genitourinary trauma. Although the etiology differs between developed and developing countries, the principles of fistula repair must be strictly adhered to for success. Timing and route of repair remain contentious, because of a lack of randomized data. Evaluation and management is dictated by the surgeon's experience. Minimally invasive techniques with laparoscopy and robotic technology are generating wider interest with reduced postoperative morbidity, but a transvaginal technique should be in the arsenal of all pelvic reconstructive surgeons. More research is required to evaluate the optimal surgical route and technique for successful outcomes.
膀胱阴道瘘是泌尿生殖系统创伤最常见的后遗症。尽管发达国家和发展中国家的病因有所不同,但瘘管修复原则必须严格遵守才能取得成功。由于缺乏随机数据,修复的时机和途径仍存在争议。评估和管理取决于外科医生的经验。腹腔镜和机器人技术等微创技术因术后发病率降低而受到越来越广泛的关注,但经阴道技术应是所有盆腔重建外科医生的技能储备。需要更多研究来评估成功治疗的最佳手术途径和技术。