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目的:探讨经腹径路手术治疗膀胱阴道瘘的临床疗效。方法:回顾性分析14例女性膀胱阴道瘘患者资料。患者平均年龄41.36岁。临床表现不同程度阴道漏尿,或伴血尿及膀胱刺激症状。膀胱镜检、膀胱尿道造影及CT三维重建术前确诊。先后行经腹径路膀胱阴道瘘修复手术,其中采取经膀胱径路9例,膀胱外径路5例。结果:14例术后随访9～103个月,平均46.26个月。2例术后出现再次膀胱阴道瘘,行二次修补手术后未再复发,1例出现切口感染,经对症处理后愈合,其余患者均未出现尿瘘复发及其他严重并发症。结论:经腹径路手术治疗膀胱阴道瘘,术中视野暴露充分,易于获取带蒂支持组织,尤其对于复杂性膀胱阴道瘘及合并输尿管等组织损伤可疑患者,是一种可行的手术治疗方式。
Objective: To investigate the clinical effect of transabdominal surgery on vesicovaginal fistula. Methods: A retrospective analysis of 14 cases of female patients with vesicovaginal fistula data. The average age of patients was 41.36 years. Clinical manifestations of varying degrees of vaginal leakage, or with hematuria and bladder irritation. Cystoscopy, bladder and urethroplasty and CT three-dimensional reconstruction of preoperative diagnosis. He has been through the abdominal route of vesicovaginal fistula repair surgery, which adopted the 9 cases of bladder pathways, bladder pathways in 5 cases. Results: Fourteen patients were followed up for 9-103 months with an average of 46.26 months. Two cases of recurrent vesico-vaginal fistula occurred after operation. No recurrence occurred after secondary repair operation. One case had incision infection and healed after symptomatic treatment. No recurrence of urinary fistula and other serious complications occurred in the remaining cases. CONCLUSION: Transvaginal approach for the treatment of vesico-vaginal fistula has sufficient intraoperative visual field exposure and easy access to pedicled support tissues. It is a feasible surgical treatment especially for patients with complex vesico-vaginal fistula and suspected ureteral tissue damage.