Rajaian Shanmugasundaram, Pragatheeswarane Murugavaithianathan, Panda Arabind
Department of Urology, MIOT International, Chennai, Tamil Nadu, India.
Department of Urology, KIMS Hospitals, Secunderabad, Telangana, India.
Indian J Urol. 2019 Oct-Dec;35(4):250-258. doi: 10.4103/iju.IJU_147_19.
Vesicovaginal fistula (VVF) is an abnormal communication between the bladder and the vagina. Prompt diagnosis and timely repair are essential for successful management of these cases. As the clinical scenario is variable, it is difficult to frame uniform guidelines for the management of VVF. Hence, the management protocol is dependent on the treating surgeon and the available resources. Conservative methods should be used in carefully selected patients. Delayed repair is better than the early repair of VVF. Transvaginal route for repair is preferred as it has low morbidity, higher success rates, and minimal complications. Anticholinergics should be used in the postoperative period for better chance of bladder healing. When facilities are available, all the patients may be referred to a tertiary care center where expertise and advanced resources are available. Trained surgeons adapting the new trends should refine the art of VVF repair.
膀胱阴道瘘（VVF）是膀胱与阴道之间的异常通道。及时诊断和适时修复对于成功处理这些病例至关重要。由于临床情况各异，很难制定统一的膀胱阴道瘘管理指南。因此，管理方案取决于主治外科医生和可用资源。对于精心挑选的患者应采用保守方法。膀胱阴道瘘延迟修复优于早期修复。经阴道修复途径更受青睐，因为其发病率低、成功率高且并发症少。术后应使用抗胆碱能药物以增加膀胱愈合的机会。若有条件，所有患者都可转诊至具备专业知识和先进资源的三级护理中心。适应新趋势的训练有素的外科医生应完善膀胱阴道瘘修复技术。
