Female Pelvic Medicine and Reconstructive Surgery Division, Department of Obstetrics & Gynecology, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Urology Division, Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Medicina (Kaunas). 2023 Nov 3;59(11):1947. doi: 10.3390/medicina59111947.
Vesicovaginal fistulas (VVFs) are an abnormal communication between the vagina and bladder and the most common type of acquired genital fistulas. This review will address the prevalence, impact, and management challenges of VVFs. Epidemiologic studies examining VVFs are considered. In addition, publications addressing the treatment of VVFs are reviewed. VVFs in developing countries are often caused by obstructed labor, while most VVFs in developed countries have iatrogenic causes, such as hysterectomy, radiation therapy, and infection. The reported prevalence of VVFs is approximately 1 in 1000 post-hysterectomy patients and 1 in 1000 deliveries. VVFs affect every aspect of quality of life, including physical, mental, social, and sexual aspects. Prevention of VVFs is essential. Early diagnosis is necessary to reduce morbidity. Nutrition, infection control, and malignancy detection are important considerations during evaluation and treatment. Conservative and surgical treatment options are available; however, these approaches should be customized to the individual patient. The success rate of combined conservative and surgical treatments exceeds 90%. VVFs are considered debilitating and devastating. However, they are preventable and treatable; key factors include the avoidance of prolonged labor, careful performance of gynecologic surgery, and early detection.
膀胱阴道瘘（VVF）是阴道和膀胱之间的异常通道，是最常见的获得性生殖器瘘。本文将讨论 VVF 的流行率、影响和管理挑战。对研究 VVF 的流行病学研究进行了考察。此外，还回顾了关于 VVF 治疗的出版物。发展中国家的 VVF 通常由梗阻性分娩引起，而发达国家的大多数 VVF 则由医源性原因引起，如子宫切除术、放射治疗和感染。报道的 VVF 流行率约为每 1000 例子宫切除术后患者 1 例和每 1000 例分娩 1 例。VVF 影响生活质量的各个方面，包括身体、心理、社会和性方面。预防 VVF 至关重要。早期诊断可降低发病率。在评估和治疗过程中，营养、感染控制和恶性肿瘤检测是重要的考虑因素。保守和手术治疗选择都可用；然而，这些方法应根据个体患者进行定制。联合保守和手术治疗的成功率超过 90%。 VVF 被认为是使人衰弱和毁灭性的。但是，它们是可预防和可治疗的；关键因素包括避免长时间分娩、仔细进行妇科手术和早期发现。
