带蒂膀胱瓣修补膀胱阴道瘘38例疗效分析

目的：探讨带蒂膀胱肌瓣修补膀胱阴道瘘的临床疗效。方法：对我院38例行带蒂膀胱肌瓣覆盖修补膀胱阴道瘘患者进行回顾性分析。初次修补患者22例，二次以上修补患者16例；单纯瘘口修补术25例，修补并输尿管膀胱再植术13例。结果：38例患者中有37例获得随访，1例失访。一次手术成功率94.59％（35／37）；1例手术失败，行二次修补治愈；1例术后出现膀胱缝合口漏尿，留置导尿2周后消失。术后随访患者均未出现阴道漏尿，6例患者出现轻度。肾积水，13例患者出现轻度尿失禁。结论：利用带蒂膀胱瓣覆盖修补瘘口是治疗膀胱阴道瘘的有效方法。

Vesicovaginal Fistula Repair Using Pedicle Bladder Flap:38 Cases Report

Objective：To investigate the clinical efficacy of using bladder flap pedicle to repair vesicovaginal fistula. Methods：To review 38 patients with vesicovaginal fistula repaired by pedicle bladder flap. The initial repair in 22 cases, two or more times of repair in 16 cases. Simple vesicovaginal fistula repair in 25 cases, vesicovaginal fistula repair with ureter replantation in 13 cases. Results：Of 38 patients, 37 cases were followed up, 1 case was lost. 35 cases were successfully repaired by first operation, success rate is 94.59 percent （35/37）, one case was failed in first operation, cured after second repair; One case with bladder suture leak after operation, disappeared after catheterization for two weeks. Patients had no vaginal leak performance during follow up, 6 cases were found mild hydronephrosis, 13 patients with mild urinary incontinence. Conclusions：The use of pedicle bladder flap to repair vesicovaginal fistula is an effective treatment method.