Ruan Jie, Zhang Li, Duan Mei-Fan, Luo De-Yi
Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases in Women and Children of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Clin Cases. 2022 May 6;10(13):4177-4184. doi: 10.12998/wjcc.v10.i13.4177.
Augmentation cystoplasty, first described by Mikulicz in 1899 involves segments of bowel, stomach or mega-ureter to increase bladder capacity in those with inadequate bladder function or lack of detrusor compliance. The most widely used bowel segment is a detubularised patch of ileum. When ileum is not suitable for augmentation, sigmoid colon is the alternative. However, only eight pregnancies after sigmoidocystoplasty have been reported without detail and clinicians may be uncertain about the effects of sigmoidocystoplasty on reproductive health and pregnancy.
We followed the patient from gestational week 32+3 until 6 wk after delivery. During pregnancy, our patient suffered urinary tract infection twice and had to undergo percutaneous nephrostomy drainage due to progressive hydronephrosis. Despite a dense adhesion between the uterus and neobladder, we were able to deliver a healthy baby by cesarian section in the presence of the attending urologist.
Augmentation cystoplasty-afflicted women can have a healthy reproductive life. Certain perioperative measures may be advisable to avoid serious surgical complications.
1899年米库利奇首次描述的膀胱扩大术，是采用肠段、胃或巨输尿管来增加膀胱功能不全或逼尿肌顺应性缺乏患者的膀胱容量。最常用的肠段是去管状化的回肠补片。当回肠不适合用于扩大术时，乙状结肠是替代选择。然而，仅报道过8例乙状结肠膀胱扩大术后妊娠的病例，且无详细情况，临床医生可能不确定乙状结肠膀胱扩大术对生殖健康和妊娠的影响。
我们对该患者从孕32⁺³周一直随访至产后6周。孕期，我们的患者发生了两次尿路感染，并且由于进行性肾积水不得不接受经皮肾造瘘引流。尽管子宫与新膀胱之间粘连紧密，但在主治泌尿科医生在场的情况下，我们通过剖宫产成功分娩出一名健康婴儿。
接受膀胱扩大术的女性能够拥有健康的生殖生活。采取某些围手术期措施可能有助于避免严重的手术并发症。
