Blaivas J G, Heritz D M, Romanzi L J
Urology Department, New York Hospital-Cornell Medical Center, New York.
J Urol. 1995 Apr;153(4):1110-2; discussion 1112-3.
We reviewed retrospectively 24 consecutive women who presented with a vesicovaginal fistula repaired by a single surgeon between 1989 and 1993. All patients underwent preoperative investigation, including cystoscopy, excretory urography and bilateral retrograde pyelography. Followup ranged from 6 months to 5 years. Postoperatively, 96% of the women were cured. Two patients had persistent symptomatic detrusor instability and 1 had mild stress incontinence. In 1 woman a vaginal repair failed and she was subsequently cured after an abdominal repair. Five patients presented 6 to 12 months after fistula formation. Among the other 17 patients the average interval from pelvic surgery to vesicovaginal fistula repair was 10.8 weeks. Indications for abdominal repair were indurated vaginal epithelium approximately 2 cm. in circumference around the fistula, a vault fistula with poor vaginal exposure and fistulas involving the ureters. Surgical timing and route of repair are best tailored to the individual patient.
我们回顾性研究了1989年至1993年间由同一位外科医生修复膀胱阴道瘘的24例连续女性患者。所有患者均接受了术前检查，包括膀胱镜检查、排泄性尿路造影和双侧逆行肾盂造影。随访时间为6个月至5年。术后，96%的女性治愈。2例患者存在持续性症状性逼尿肌不稳定，1例有轻度压力性尿失禁。1例女性阴道修复失败，随后经腹部修复治愈。5例患者在瘘管形成后6至12个月就诊。在其他17例患者中，从盆腔手术到膀胱阴道瘘修复的平均间隔时间为10.8周。腹部修复的指征为瘘管周围约2厘米周长的阴道上皮硬结、阴道暴露不佳的穹窿瘘以及累及输尿管的瘘管。手术时机和修复途径最好根据个体患者进行调整。
