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膀胱子宫瘘作为一种通过延迟手术修复治疗的罕见泌尿生殖系统并发症:一例病例报告及文献综述

Vesicouterine Fistula (VUF) as a Rare Urogenital Complication Managed with Delayed Surgical Repair: A Case Report and Review of the Literature.

作者信息

Symeonidis Evangelos N, Sdralis Elias, Symeonidis Asterios, Georgiadis Christos, Kalyvas Vasileios, Malioris Apostolos, Papathanasiou Michail

机构信息

Department of Urology, 424 General Military Hospital of Thessaloniki, Thessaloniki, Greece.

Department of Surgery, 424 General Military Hospital of Thessaloniki, Thessaloniki, Greece.

出版信息

Case Rep Obstet Gynecol. 2018 Oct 24;2018:2394896. doi: 10.1155/2018/2394896. eCollection 2018.

Abstract

Vesicouterine fistula (VUF) represents a rare urogenital complication. It is considered to be the least common type of urogenital fistulas. Iatrogenic reasons have been shown to be the most prominent cause, with lower segment caesarean section accounting for approximately two-thirds of the cases. The highest incidence concerns young females of reproductive age. VUF can present with clinical symptoms varying from cyclic hematuria, amenorrhea, and vaginal leakage of urine to secondary infertility and first-trimester abortion. Quality of life (QoL) for patients having this pathology is strongly affected due to the psychological burden. Surgical excision of the fistula remains the mainstay of treatment, as less than 5% of patients respond to conservative therapy. Recently laparoscopic and robotic-assisted VUF repair started gaining ground with comparable results to open surgery. Herein, we presented the successful delayed surgical repair of VUF in a 32-year-old female patient. A review of the published literature was also performed, summarizing all the available evidence regarding this rare clinical entity.

摘要

膀胱子宫瘘(VUF)是一种罕见的泌尿生殖系统并发症。它被认为是泌尿生殖瘘中最不常见的类型。医源性原因已被证明是最主要的病因,下段剖宫产约占病例的三分之二。发病率最高的是育龄期年轻女性。VUF的临床症状多样,从周期性血尿、闭经、尿液经阴道漏出到继发性不孕和早期流产。患有这种疾病的患者的生活质量(QoL)因心理负担而受到严重影响。瘘管的手术切除仍然是主要的治疗方法,因为不到5%的患者对保守治疗有反应。最近,腹腔镜和机器人辅助的VUF修复开始得到广泛应用,其结果与开放手术相当。在此,我们展示了一名32岁女性患者成功进行的VUF延迟手术修复。我们还对已发表的文献进行了综述,总结了关于这种罕见临床实体的所有现有证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e135/6220400/17085eb41f58/CRIOG2018-2394896.001.jpg

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