Toia Bogdan, Ockrim Jeremy J, Greenwell Tamsin J
Department of Urology, University College London Hospital, 16-18 Westmoreland Street, London W1G 9PH, UK.
J Surg Case Rep. 2019 Aug 14;2019(8):rjz235. doi: 10.1093/jscr/rjz235. eCollection 2019 Aug.
Vesicovaginal fistulae (VVF) and ureteric reimplantation are two rare complications of obstetric surgery. VVF can be repaired via a vaginal approach utilizing Martius fat pad interposition to minimize urethral complications and improve surgical outcomes, while ureteric reimplantation into the bladder classically necessitates an abdominal or laparoscopic approach. We present a new technique of ureteric reimplantation via vaginal approach with concomitant repair of a 5-cm VVF in a 25-year-old woman after an emergency caesarean section with bladder injury and ureteric transection. Good drainage was confirmed on MAG3 and successful vaginal birth (albeit preterm) was subsequently achieved.
膀胱阴道瘘（VVF）和输尿管再植术是产科手术中两种罕见的并发症。膀胱阴道瘘可通过阴道入路，利用Martius脂肪垫植入术进行修复，以尽量减少尿道并发症并改善手术效果，而经典的输尿管膀胱再植术则需要经腹或腹腔镜入路。我们介绍了一种经阴道入路进行输尿管再植术的新技术，同时修复了一名25岁女性在急诊剖宫产术后出现膀胱损伤和输尿管横断的5厘米膀胱阴道瘘。肾图证实引流良好，随后成功实现了阴道分娩（尽管是早产）。
