Fernandes Miguel, Miranda Miguel, Lopes Filipe, Pereira Sérgio, Reis José Palma, Martins Francisco
Unidade Local de Saúde de Santa Maria, Urology Department, Av. Professor Egas Moniz, 1649-035, Lisboa, Portugal.
Urol Case Rep. 2025 Jan 9;59:102932. doi: 10.1016/j.eucr.2025.102932. eCollection 2025 Mar.
Neobladder-vaginal fistula (NVF) is a rare complication after radical cystectomy with orthotopic neobladder, impacting patient quality of life. This case report describes successful transvaginal, multilayered closure of NVF in a 59-year-old woman with urinary incontinence post-surgery. Despite prior intraoperative repair, an 8mm fistula was detected and repaired transvaginally. A watertight test confirmed closure, and the patient remained continent at 22 months follow-up. NVF rates range from 3 to 6%, with risk factors including poor vaginal vascularity and intraoperative injury. This case supports transvaginal repair as an initial approach, with further research needed to refine NVF management strategies.
新膀胱阴道瘘(NVF)是原位新膀胱根治性膀胱切除术后一种罕见的并发症,会影响患者的生活质量。本病例报告描述了一名59岁术后尿失禁女性经阴道多层成功闭合NVF的情况。尽管之前进行了术中修复,但仍检测到一个8毫米的瘘管,并经阴道进行了修复。水密试验证实了闭合情况,患者在22个月的随访中保持了控尿。NVF的发生率在3%至6%之间,危险因素包括阴道血运差和术中损伤。本病例支持将经阴道修复作为初始治疗方法,还需要进一步研究以完善NVF的管理策略。