女性尿瘘的治疗体会(附13例报告)

目的　探讨女性尿瘘的诊治,对巨大复杂的膀胱尿道阴道瘘的手术修补法进行探讨。方法　经阴道修补膀胱阴道瘘4例, 尿道阴道瘘3例,膀胱尿道阴道瘘2例,经腹阴道联合途径修补复杂性女性尿瘘4例,其中输尿管阴道瘘1例。结果　一次性修 复痊愈率(甲级)达84.6%、有效率(乙级)达92.3%。结论　术前仔细检查及评估手术方案是缩短手术时间、减少术中创伤的重 要环节,精细的外科手术技巧是确保手术成功的关键,经腹阴道联合手术途径修补术是治疗巨大复杂女性尿瘘的有效方法。

Operations of vesicova-urethral-vaginal fistulas (report of 13 cases)

Objective To study the diagnosis and treatment of urethral vaginal fistulas, especially huge and complex urinary fistulas. Methods From 2002 to 2003, 4 cases of vesicova vaginal fistula, 3 cases of urethral vaginal fistulas and 2 cases of vesicova-urethral-vaginal fistulas were treated by transvaginal operation. Four cases of complex vesicova-urethral-vaginal were repaired with combined abdominal-vaginal operation. Results The cure rate after one prothesis was 84.6% and effective rate was 92.3%. All the patients had been followed up for 1-7 months with satisfactory result. Repair of vaginal fistula was recommended. Conclusion Fistula repair by combined abdominal-vaginal prothesis is good way to treat huge and complex urinary fistulas. Correct diagnosis, preoperative examination and evaluation, and refined operation techniaues are very important in the success of the treatment.