Goodwin W E, Scardino P T
Trans Am Assoc Genitourin Surg. 1979;71:123-9.
The difficult problem of a vesicovaginal fistula originally was cured surgically by Sims in 1849. During the last 25 years at UCLA and affiliated hospitals 68 patients have been treated by urologic surgeons for fistulas between the vagina and the urinary tract: 21 ureterovaginal and 47 vesicovaginal and urethrovaginal fistulas. The ureterovaginal fistulas often were complex and patients presented the most challenging diagnostic problem. However, they usually were repaired successfully by simple ureteroneocystostomy. Vesicovaginal and urethrovaginal fistulas were repaired transvaginally in 24 cases, with 70% success at the first attempt and 92% success with 2 attempts. Transabdominal or combined approaches were less successful. Only 58% of the cases were closed at first attempt. The transvaginal approach required less operating time, and resulted in less blood loss and shorter hospital stays than the transabdominal approach and will be described in detail.
膀胱阴道瘘这一难题最初在1849年由西姆斯通过手术治愈。在过去25年里，加州大学洛杉矶分校及其附属医院的泌尿外科医生共治疗了68例阴道与泌尿道之间瘘管的患者：21例输尿管阴道瘘以及47例膀胱阴道瘘和尿道阴道瘘。输尿管阴道瘘通常情况复杂，给患者的诊断带来了最具挑战性的问题。然而，通过简单的输尿管膀胱吻合术通常能成功修复。24例膀胱阴道瘘和尿道阴道瘘经阴道修复，首次尝试成功率为70%，两次尝试成功率为92%。经腹或联合手术方式成功率较低。首次尝试时仅有58%的病例得以闭合。与经腹手术方式相比，经阴道手术方式所需手术时间更短，出血量更少，住院时间更短，本文将对此进行详细描述。
