Marks P, Kluth L A, Lang I J, Fisch M
Klinik und Poliklinik für Urologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20251, Hamburg, Deutschland.
Klinik für Urologie, Universitätsklinikum Frankfurt, Frankfurt a.M., Deutschland.
Urologe A. 2020 Apr;59(4):432-441. doi: 10.1007/s00120-020-01155-3.
Vesicovaginal fistulas (VVF) represent a detrimental condition causing psychological, physical and social strain on patients. In developed countries they are predominantly the result of pelvic surgery or radiation therapy, whilst obstetric VVF are common in developing countries due to prolonged and complicated births. The majority of VVF require surgical therapy, thus a comprehensive diagnostic workup is needed. Depending on diagnostic characteristics fistula repair can be performed by a transvaginal, transabdominal or minimally invasive approach. Timing of surgery, appropriate interposition of vascularized grafts, optimized postoperative management and surgical expertise are determining factors for successful treatment. This review describes the diagnostic workup and therapeutic management of VVF including various surgical techniques.
膀胱阴道瘘（VVF）是一种有害病症，会给患者带来心理、身体和社会压力。在发达国家，它们主要是盆腔手术或放射治疗的结果，而产科膀胱阴道瘘在发展中国家因分娩时间长且复杂而很常见。大多数膀胱阴道瘘需要手术治疗，因此需要进行全面的诊断检查。根据诊断特征，瘘管修复可通过经阴道、经腹或微创方法进行。手术时机、带血管移植物的适当植入、优化的术后管理和手术专业知识是成功治疗的决定性因素。本综述描述了膀胱阴道瘘的诊断检查和治疗管理，包括各种手术技术。
