al-Rifaei M, el-Salmy S, al-Rifaei A, Salama A
Urology Department, Alexandria University, Egypt.
Scand J Urol Nephrol. 1996 Aug;30(4):287-9. doi: 10.3109/00365599609182308.
Vesicouterine and vesicocervical fistula are mostly caused by trauma during lower segment caesarian section. The clinical presentation and management of nine cases are described. Presentation was typical, i.e. cyclic haematuria (menouria) without urinary leakage, in three of the nine patients, and atypical--vaginal leakage of urine, urethral passage of lochia and/or regular vaginal menes--in six patients. The diagnosis was made clinically, radiologically and endoscopically. Surgical repair was successfully performed in eight cases and one was managed conservatively with satisfactory outcome. Atypical presentation of such fistulas may considerably delay the diagnosis. In contrast to vesicovaginal fistula, conservative management may be tried in selected cases.
膀胱子宫瘘和膀胱宫颈瘘大多由下段剖宫产术中的创伤引起。本文描述了9例患者的临床表现及治疗情况。9例患者中，3例表现典型，即周期性血尿（月经性血尿）且无尿液渗漏；6例表现不典型，即尿液经阴道漏出、恶露经尿道排出和/或有规律的阴道出血。通过临床、影像学和内镜检查做出诊断。8例患者成功接受了手术修复，1例采用保守治疗，效果满意。此类瘘管的不典型表现可能会大大延迟诊断。与膀胱阴道瘘不同，在某些特定病例中可尝试保守治疗。
