Benchekroun A, Lachkar A, Soumana A, Farih M H, Belahnech Z, Marzouk M, Faik M
Clinique Urologique A, CHU Ibn Sina, Rabat, Maroc.
Ann Urol (Paris). 1998;32(5):295-9.
The authors report a series of 45 cases of ureterovaginal fistula (UVF) observed over a 25-year period. The patients had a mean age of 34 years (20 to 50 years). 32 UVF (71%) were secondary to obstetric procedures and operations and 13 UVF (29%) were due to hysterectomy for gynaecological diseases. The clinical features were dominated by urine leak via the vagina with persistent micturition (68.8%) and low back pain (40%). UVF was associated with vesicovaginal fistula in 11 patients and acute renal failure was observed in 4 patients. IVU confirmed the diagnosis in 36 patients (87%) and revealed 23 cases of uretero-hydronephrosis and 4 silent kidneys. Retrograde ureteropyelography, performed in 4 cases, confirmed the diagnosis of UVF. The lesion was situated on the right side in 26 patients and was bilateral in the other 3 patients. The commonest lesion was section (48.8%). Treatment consisted of ureterovesical reimplantation (27 cases), Boari-Küss bladder flap of (3 cases), psoas bladder (5 cases), nephrectomy (2 cases), end-to-end anastomosis (2 cases), appendico-ureteroplasty (2 cases), double J stent (2 cases) and ileoureteroplasty (1 case). The course was favourable in 35 patients (77%).
作者报告了在25年期间观察到的一系列45例输尿管阴道瘘（UVF）病例。患者的平均年龄为34岁（20至50岁）。32例UVF（71%）继发于产科手术和操作，13例UVF（29%）是由于妇科疾病行子宫切除术所致。临床特征主要为经阴道漏尿伴持续性尿频（68.8%）和腰痛（40%）。11例患者合并膀胱阴道瘘，4例患者出现急性肾衰竭。静脉肾盂造影（IVU）在36例患者（87%）中确诊，并发现23例输尿管肾积水和4例静息肾。4例行逆行输尿管肾盂造影，确诊为UVF。病变位于右侧26例，其余3例为双侧。最常见的病变是输尿管切断（48.8%）。治疗方法包括输尿管膀胱再植术（27例）、Boari-Küss膀胱瓣术（3例）、腰大肌膀胱术（5例）、肾切除术（2例）、端端吻合术（2例）、阑尾输尿管成形术（2例）、双J支架置入术（2例）和回肠代输尿管术（1例）。35例患者（77%）病情好转。
