Division of Urogynecology and Reconstructive Pelvic Surgery, Oregon Health & Science University, Portland, OR, USA.
Int Urogynecol J. 2024 Apr;35(4):925-928. doi: 10.1007/s00192-024-05753-z. Epub 2024 Mar 9.
Because complete urinary bladder eversion is rare, a medical dilemma exists on the optimal treatment approach. The most extensive cases of this disorder have required a laparotomy for definitive management. Our transvaginal approach in this case provides an additional surgical perspective, which could potentially guide clinical care for patients with this disorder.
We cared for a 76-year-old multiparous, postmenopausal woman with transurethral bladder eversion following a Le Fort colpocleisis, who presented with vaginal pain, bleeding, and renal failure. We used a transvaginal surgical approach rather than laparotomy as a novel surgical approach for treatment of the bladder eversion, which resulted in improved symptoms and renal function. We describe our diagnostic and decision making approach used for the care of this unique patient.
Transvaginal bladder neck closure and suprapubic catheter placement is an acceptable and less invasive alternative to the laparotomy with cystopexy for the surgical management of recurrent bladder eversion.
由于完全性膀胱外翻罕见，因此在治疗方法上存在医学困境。这种疾病最严重的情况需要剖腹手术来明确处理。我们在这个病例中采用的经阴道入路为这种疾病的治疗提供了另一种手术视角，可能为这类患者的临床治疗提供指导。
我们治疗了一位 76 岁的经产妇绝经后妇女，她在接受 Le Fort 阴道闭孔成形术后发生经尿道膀胱外翻，表现为阴道疼痛、出血和肾衰竭。我们采用经阴道手术入路而不是剖腹手术作为治疗膀胱外翻的新方法，这导致症状和肾功能改善。我们描述了我们用于治疗这个独特患者的诊断和决策方法。
经阴道膀胱颈闭合和耻骨上导尿管放置是治疗复发性膀胱外翻的替代剖腹手术和膀胱固定术的一种可接受且微创的方法。
