Tancer M L
Sloane Hospital for Women, New York, New York.
Surg Gynecol Obstet. 1993 Jul;177(1):77-80.
The current study was done to outline problems noted by an individual surgeon in his experience with the management of urethrovaginal and bladder neck fistulas. Twenty-six women with intact urethras distal to the fistulas had transvaginal layered closures. Five women with completely destroyed posterior urethral walls had transvaginal reconstructions. Three women with special findings had individualized surgical repairs. Successful function, as well as anatomic results, were obtained in 23 of 26 women in the first group, two of five women in the second group and all three women in the third group. An uncomplicated urethrovaginal or bladder neck fistula may be repaired successfully by a transvaginal layered closure. The repair of a complicated fistula, one which is radiation-induced or one in which the entire posterior urethra has been destroyed, may result in functional failure despite an apparently successful anatomic result. The method by which bladder drainage after fistula operation is performed does not effect the result.
本研究旨在概述一位外科医生在处理尿道阴道瘘和膀胱颈瘘的经验中所注意到的问题。26例瘘口远端尿道完整的女性接受了经阴道分层缝合。5例后尿道壁完全毁损的女性接受了经阴道重建术。3例有特殊情况的女性接受了个体化手术修复。第一组26例女性中有23例、第二组5例女性中有2例以及第三组所有3例女性均获得了成功的功能及解剖学结果。单纯的尿道阴道瘘或膀胱颈瘘可通过经阴道分层缝合成功修复。复杂瘘（如放射性瘘或整个后尿道已毁损的瘘）的修复，尽管解剖学结果看似成功，但仍可能导致功能失败。瘘手术后膀胱引流的方法不影响结果。
