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剖宫产术后膀胱-子宫瘘:病例报告及文献复习。

Vesico-uterine Fistula Following C-section - A Case Report and Literature Review.

机构信息

Department of Obstetrics and Gynecology, "Dr. I. Cantacuzino" Clinical Hospital, Bucharest, Romania.

Department of Surgery "Ponderas" Academic Hospital, Bucharest, Romania;

出版信息

In Vivo. 2022 Jan-Feb;36(1):528-532. doi: 10.21873/invivo.12734.

DOI:10.21873/invivo.12734
PMID:34972758
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8765147/
Abstract

BACKGROUND/AIM: Vesico-uterine fistulas represent a rare type of genito-urinary fistulas; however, due to the increasing incidence of Caesarean section (C-section) in the last decade, this abnormal communication between the urinary and genital tracts has been reported more often after such surgical procedures. The aim of the current article was to report the case of a 28-year-old patient who was submitted to surgery for a vesico-uterine fistula seven years after a C-section.

CASE REPORT

The 28-year-old patient with a previous history of four vaginal deliveries and one C-section was self-presented to the Gynecology Department for cyclic hematuria and diagnosed with a vesico-uterine fistula after injecting methylene blue in the uterine cavity during hysteroscopy. The patient was further submitted to surgery, and a parcelar myometrectomy en bloc with parcelar cystectomy, cystography, and prophylactic salpingectomy was performed. The postoperative outcome was uneventful.

CONCLUSION

Although vesico-uterine fistulas represent rare events, they should be considered, especially in young patients with a previous history of C-section.

摘要

背景/目的:膀胱-子宫瘘是一种罕见的生殖道-泌尿道瘘,但由于过去十年剖宫产(C -section)的发生率增加,这种生殖道与泌尿道之间的异常通道在这种手术后更为常见。本文的目的是报告一例 28 岁患者,该患者在 C 剖宫产后 7 年接受了膀胱-子宫瘘手术。

病例报告

这位 28 岁的患者有四次阴道分娩和一次 C 剖宫史,因宫腔镜检查时向子宫腔注射亚甲蓝而出现周期性血尿,自行到妇科就诊,被诊断为膀胱-子宫瘘。患者进一步接受了手术,进行了部分子宫肌切除术、部分膀胱切除术、膀胱造影和预防性输卵管切除术。术后结果无并发症。

结论

尽管膀胱-子宫瘘是罕见的事件,但应予以考虑,尤其是对于有 C 剖宫史的年轻患者。

相似文献

1
Vesico-uterine Fistula Following C-section - A Case Report and Literature Review.剖宫产术后膀胱-子宫瘘:病例报告及文献复习。
In Vivo. 2022 Jan-Feb;36(1):528-532. doi: 10.21873/invivo.12734.
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Cyclic hematuria after cesarean section: MRI image indicates vesico-uterine fistula.剖宫产术后周期性血尿:磁共振成像(MRI)显示膀胱子宫瘘。
Arch Gynecol Obstet. 2022 Oct;306(4):1357-1358. doi: 10.1007/s00404-022-06707-w. Epub 2022 Jul 30.
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[Ultrasound diagnosis of vesico-uterine fistula].
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[Uterine bladder fistula after a cesarean. A case report].[剖宫产术后膀胱阴道瘘。病例报告]
J Gynecol Obstet Biol Reprod (Paris). 1992;21(1):112-8.
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[A patient with a vesico-uterine fistula].[一名患有膀胱子宫瘘的患者]
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9
[Uncommon form of vesico-uterine fistula].[膀胱子宫瘘的罕见形式]
J Gynecol Obstet Biol Reprod (Paris). 1976 Jun;5(4):535-42.
10
Vesico-uterine fistula occurring in a woman with a previous caesarean section and two subsequent normal vaginal deliveries.膀胱子宫瘘发生在一名有既往剖宫产史且随后有两次正常阴道分娩史的女性身上。
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Res Rep Urol. 2025 May 16;17:159-165. doi: 10.2147/RRU.S510290. eCollection 2025.
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Obstetric vesico-uterine fistula in nine reference hospitals in the Democratic Republic of the Congo: epidemiological, clinical, and therapeutic aspects.刚果民主共和国 9 所参考医院的产科膀胱-子宫瘘:流行病学、临床和治疗方面。
BMC Womens Health. 2024 May 23;24(1):309. doi: 10.1186/s12905-024-03124-w.
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Diagnostic and Therapeutic Challenges of Oligosymptomatic Vesicovaginal Fistula in the Complex Case of Endometriosis.子宫内膜异位症复杂病例中症状轻微的膀胱阴道瘘的诊断与治疗挑战
Clin Pract. 2024 Mar 12;14(2):436-442. doi: 10.3390/clinpract14020033.
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Gynecological Fistulae-Has Anything Changed in the Diagnosis and Treatment over the Last Decade? A Narrative Literature Review.妇科瘘管病——在过去十年中,其诊断和治疗有何变化?一项叙述性文献综述。
Medicina (Kaunas). 2023 Aug 12;59(8):1455. doi: 10.3390/medicina59081455.

本文引用的文献

1
Transvaginal repair of vesicouterine fistulae: our experience of three cases.经阴道膀胱子宫瘘修补术:我们的三例经验
Int Urogynecol J. 2022 Mar;33(3):737-740. doi: 10.1007/s00192-021-04973-x. Epub 2021 Sep 20.
2
Vesicouterine Fistula: A Robotic Approach.膀胱阴道瘘:机器人手术方法。
Int Urogynecol J. 2022 Jun;33(6):1685-1687. doi: 10.1007/s00192-021-04940-6. Epub 2021 Aug 10.
3
Repair of vesicouterine fistula by not using traditional O' connor method.不采用传统 O'connor 方法修补膀胱子宫瘘。
J Pak Med Assoc. 2021 Jan;71(1(A)):143-145. doi: 10.47391/JPMA.019.
4
Robotic repair of the symptomatic vesicouterine fistula.有症状膀胱子宫瘘的机器人修复术。
Int Urogynecol J. 2021 Jul;32(7):1945-1947. doi: 10.1007/s00192-020-04558-0. Epub 2020 Oct 20.
5
Risk factors for fistula formation after interstitial brachytherapy for locally advanced gynecological cancers involving vagina.局部晚期累及阴道的妇科癌症行组织间近距离放射治疗后瘘管形成的危险因素。
J Contemp Brachytherapy. 2018 Dec;10(6):510-515. doi: 10.5114/jcb.2018.80171. Epub 2018 Dec 28.
6
Vesicouterine Fistula (Youssef Syndrome): Case Report and Literature Review.膀胱子宫瘘(优素福综合征):病例报告及文献综述
Rev Bras Ginecol Obstet. 2018 Sep;40(9):563-569. doi: 10.1055/s-0038-1666998. Epub 2018 Sep 19.
7
Repair of a vesicouterine fistula following cesarean section.剖宫产术后膀胱子宫瘘的修复
Int Urogynecol J. 2018 Feb;29(2):309-311. doi: 10.1007/s00192-017-3506-1. Epub 2017 Nov 16.
8
Incidentally diagnosed post-cesarean vesicouterine fistula (Youssef's syndrome).偶然诊断出的剖宫产术后膀胱子宫瘘(尤塞夫综合征)。
Can Urol Assoc J. 2015 Nov-Dec;9(11-12):E913-5. doi: 10.5489/cuaj.3258. Epub 2015 Dec 14.
9
Youssef's Syndrome following Cesarean Section.剖宫产术后的优素福综合征。
Case Rep Obstet Gynecol. 2015;2015:605325. doi: 10.1155/2015/605325. Epub 2015 Sep 17.
10
Vesicouterine fistula, a rare cause of genitourinary fistula.膀胱子宫瘘是泌尿生殖瘘的一种罕见病因。
Turk J Urol. 2014 Dec;40(4):251-4. doi: 10.5152/tud.2014.70846. Epub 2014 Oct 15.