女性泌尿生殖瘘的治疗：经膀胱还是经阴道途径？
Management of female genitourinary fistulas: transvesical or transvaginal approach?
作者信息
Leng W W, Amundsen C L, McGuire E J
机构信息
Department of Obstetrics and Gynecology, University of Texas-Houston Medical School, USA.
出版信息
J Urol. 1998 Dec;160(6 Pt 1):1995-9. doi: 10.1097/00005392-199812010-00013.
PURPOSE
We reviewed 25 female genitourinary fistula repairs performed at our institution from 1993 to 1997.
MATERIALS AND METHODS
Our series comprised 7 primary vesicovaginal, 6 recurrent vesicovaginal, 7 complex, 1 ureterovaginal and 4 urethrovaginal fistulas. Postoperative followup ranged from 8 months to 5 years.
RESULTS
Overall, 92% of the patients were cured (23 of 25). The 2 failures occurred in patients with a history of pelvic malignancy involving adjuvant therapy.
CONCLUSIONS
Complex irradiated vesicovaginal fistulas require staged repairs, often with pedicle flaps. However, primary repair of uncomplicated vesicovaginal fistulas is highly successful. Limited transvesical repair of these fistulas offers reliable success with minimal morbidity and hospital stay comparable to those of the transvaginal approach.
目的
我们回顾了1993年至1997年在本机构进行的25例女性泌尿生殖瘘修补术。
材料与方法
我们的病例系列包括7例原发性膀胱阴道瘘、6例复发性膀胱阴道瘘、7例复杂性瘘、1例输尿管阴道瘘和4例尿道阴道瘘。术后随访时间为8个月至5年。
结果
总体而言，92%的患者治愈（25例中的23例）。2例失败发生在有盆腔恶性肿瘤并接受辅助治疗病史的患者中。
结论
复杂性放射性膀胱阴道瘘需要分期修复，通常采用带蒂皮瓣。然而，单纯性膀胱阴道瘘的一期修复成功率很高。这些瘘的有限经膀胱修复成功率可靠，发病率极低，住院时间与经阴道手术相当。
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