Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi, Pakistan.
Department of Obstetrics and Gynaecology, The Aga Khan University Hospital, Karachi.
J Pak Med Assoc. 2021 Jan;71(1(A)):143-145. doi: 10.47391/JPMA.019.
A 25-year-old female patient visited our clinic with complaint of cyclic haematuria. She had previous two Caesarean Sections at a secondary care hospital. Her complete urinalysis showed abundant red blood cells. Through computed tomography a fistula tract between the posterior wall of the bladder and the anterior wall of the lower uterine segment was diagnosed. The Cystoscopy revealed a fistulous opening with a diameter of nearly 1.5 cm localized between the bladder and uterine cavity. Fistulae was repaired by abdominal approach without transection of bladder. Surgery was performed by mobilization of bladder and wide anterior uterine dissection. A 2cm defect in the lower uterine segment was identified and was closed with 0 polyglycolic acid suture. Bladder defect was repaired in two layers and omental tissue flap was placed between the two surfaces. At 6 months follow the up patient was asymptomatic.
一位 25 岁的女性患者因周期性血尿就诊于我院。她曾在一家二级医院行两次剖宫产术。其完整的尿液分析显示大量红细胞。通过计算机断层扫描，诊断为膀胱后壁与子宫下段前壁之间的瘘管通道。膀胱镜检查显示在膀胱和子宫腔之间有一个直径近 1.5 厘米的瘘口。通过腹部途径修复瘘管，不横断膀胱。手术通过膀胱的移动和广泛的子宫前部分离来进行。发现子宫下段有 2cm 的缺损，并使用 0 聚乙二醇酸缝线进行缝合。膀胱缺损分两层修复，并在两层之间放置网膜组织瓣。在 6 个月的随访中，患者无症状。
