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.
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.
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。
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