Memon M A, Zieg D A, Neal P M
Department of Surgery, Rush Presbyterian-St. Luke's Medical Center, Chicago, IL 60612, USA.
Scand J Urol Nephrol. 1998 Jul;32(4):293-5. doi: 10.1080/003655998750015485.
This report concerns an extremely rare type of fistula, a vesicouterine fistula, in a 59-year-old female occurring twenty years following brachytherapy for cervical cancer. The patient presented with a history of recurrent urinary tract infections, sensation of incompletely emptying the bladder, nocturia and constant leakage of urine for several months. Cystoscopy revealed a fistulous opening and an exophytic lesion on the posterior bladder wall. Contrast computerized tomography demonstrated a fistulous tract between the posterior bladder wall and the anterior aspect of the uterine cavity. She underwent a hysterectomy, excision of the bladder fistula and interposition of a vascularized rectus muscle graft. Histology of the cervix and bladder only revealed inflammatory changes with no evidence of malignancy. The diagnosis and investigation of this extremely rare condition are discussed, and the management strategies outlined.
本报告涉及一名59岁女性的一种极其罕见的瘘管——膀胱子宫瘘，该瘘管在宫颈癌近距离放疗20年后出现。患者有反复尿路感染病史，感觉膀胱排空不全、夜尿症，且持续数月尿液渗漏。膀胱镜检查发现膀胱后壁有一个瘘口和一个外生性病变。计算机断层扫描造影显示膀胱后壁与子宫腔前部之间有一条瘘管。她接受了子宫切除术、膀胱瘘切除术并置入带血管的腹直肌移植物。宫颈和膀胱的组织学检查仅显示炎症变化，无恶性肿瘤证据。讨论了这种极其罕见疾病的诊断和检查，并概述了治疗策略。
