罕见的膀胱臀部瘘1例报告及文献复习

目的：报告1例罕见女性膀胱臀部瘘和复习相关文献，探讨膀胱臀部瘘发病原因、形成机制及治疗原则。方法：患者18年前开始出现右臀部软组织反复感染后臀部漏尿，当地医院先后多次手术治疗无效。后转来我院行膀胱臀部瘘瘘管切除＋膀胱壁无张力修补术，膀胱臀部瘘消失，3个月后复查膀胱镜、尿道造影及尿流率检查。绪果：患者术后3个月复查膀胱镜见膀胱修补处黏膜连续完整、光滑红润，未见瘘口样改变，尿道排泄造影示膀胱充盈好，未见造影剂外渗，尿流率检查示最大尿流率35ml／s，膀胱容量305ml，随访至今尿瘘无复发。结论：膀胱臀部瘘非常罕见的，病因多较复杂，采用瘘管、周围瘢痕切除和膀胱壁分层无张力修补可取得了满意的治疗效果。

Vesical-hip fistula: a case report and review of the literature

Objective：To report a rare case of female bladder hip fistula, review the relevant literature, and in- vestigate the pathogeny, mechanism and treatment principle of bladder hip fistula. Method： The leakage of urine appeared on the patient after right buttock soft tissue repeated infection 18 years ago. The local hospital had opera- ted several times, laut all operations were failure. After admitted to our hospital, bladder hip fistula fistulectomy and bladder wall tension free hernia repair were operated. The catheter was removed postoperative 2 weeks, and cystoscopy, urethrography and uroflowmetry were carried out postoperative 3 months. Result： Postoperative 3 months cystoscopy showed urinary bladder mucosal integrity, continuous smooth rich in blood supply, and no fis- tula was caught. Urinary excretion angiography showed bladder filling good, and there is no contrast agent extrav- asation. Maximum urinary flow rate was 35 ml/s with bladder capacity of 305 ml. Urinary fistulas was undetected follow-up to now. Conclusion：Bladder hip fistula is very rare, and its pathogeny is complicated. Surgical operation can be accomplished with satisfactory curative effect.