膀胱阴道瘘18例临床分析

目的探讨妇科手术等所致膀胱阴道瘘诊断、治疗及预防措施。方法回顾性分析开封市中医院2004年2月至2012年6月间收治的18例膀胱阴道瘘患者的临床资料，18例均经膀胱镜检查和膀胱亚甲蓝试验确诊。其中1例行保守治疗，11例经膀胱修补，6例经阴道修补。结果保守治疗1例，留置尿管28d，愈合无复发；3例术后复发，1例6个月后再次修补治愈，2例肿瘤复发无修补；余14例手术均成功，术后随访6—12个月无复发。结论妇科手术致膀胱阴道瘘多见，治疗方法应根据患者的一般情况、瘘管性质及医师经验而选择。

Surgery treatments for 18 cases of vesicovaginal fistula

Objective To investigate the diagnostic, therapeutic method and precaution of vesi-covaginal fistula resulting from gynecologic and obstetric surgery. Methods The clinical data of 18 pa-tients with vesicovaginal fistula who were admitted into our hospital from February 2004 to June 2012 were analyzed retrospectively, they were all confirmed by cystoscopy and bladder methylene blue test. Inclu- ding 1 case of conservative treatment, 11 cases of bladder operation and 6 cases of transvagina repair. Re- suits One case of conservative treatment retain catheter for 28 days, was curSd and no other complica- tions occurred; Three cases occurred after operation, 1 case was cured by repaired two times after six months and 2 cases tumor recurred and didn＇ t repair. Fourteen cases were cured by operation and no other complications occurred after 1 to 12 months＇ followed-up. Conclusions Vesicovaginal fistula often occurs in the gynecologic and obstetric surgery, choose of timing of repair and surgical approach should be based on the patients＇ situation and surgeons＇ experience.