尿道憩室误伤后尿道阴道瘘1例报告并文献复习  

The urethrovaginal fistula caused by mistreatment of female urethral diverticulum:a case report and literature review

作　　者：沈希[1] 陈庆云[1] 卞美璐[1] 张冠[2] 

机构地区：[1]中日友好医院妇产科 [2]中日友好医院泌尿外科,北京100029

出　　处：《中日友好医院学报》2015年第3期143-146,F0003,共5页Journal of China-Japan Friendship Hospital

摘　　要：目的:探讨女性尿道阴道瘘的病因、临床表现、诊断与治疗方法。方法:回顾分析1例尿道憩室误伤后尿道阴道瘘患者的临床资料,并进行相关的文献复习。结果:女性生殖道瘘的病因在发达国家主要为手术外伤或手术合并症,在发展中国家多为难产。尿道阴道瘘的手术修补方法根据瘘口位置、大小、有无瘢痕有不同选择。在单纯尿瘘修补术中,采用纵行间断缝合游离的尿道粘膜、横行间断缝合游离的阴道前壁粘膜形成错位,能降低组织张力,避免新尿道挛缩,取得满意的治疗效果。本例在阴道前壁可见尿道下段后壁有1.5cm×0.8cm的瘘口,病因为42年前曾自行剪除阴道前壁赘生物。膀胱镜检查提示尿道阴道瘘,膀胱正常。全麻下行尿道阴道瘘修补术,术后3周拔除尿管时伤口愈合好,术后随访6个月无漏尿。结论:女性生殖道瘘病因多样,手术修补有良好的效果。Objective：To study the cause,clinical manifestation,diagnosis and treatment of the female ure- throvaginal fistula.Methods：Combined with reviewing the relevant literature,we retrospectively analyzed the clinical data of a case of the urethrovaginal fistula caused by mistreatment of the female urethral diverticulum. Results：The causes of urethrovaginal fistula are mainly surgical trauma or surgical complications in developed countries,mostly in developing countries during childbirth.The surgical repair methods of urethral vaginal fistu- la are different according to the fistula location,size and the presence of scar.Longitudinal interrupted suture of the free urethral mucosa and transverse interrupted suture of the free vaginal mucosa produce satisfactory treatment effect in simple repair of urethrovaginal fistula,which can reduce the tissue tension and avoid the contracture of the new urethra.We reported a 62-year-old female patient hospitalized with the leakage of urine for 42 years due to mistreatment of the urethral diverticulum.The orificium fistulae was found in the an- terior vagina by gynecological examination,the size was 1.5cmx0.8cm.Cystoscopy found a urethrovaginal fistula and a normal bladder.The patient underwent simple repair of the urethrovaginal fistula under the general anesthesia.A good wound healing was observed after the catheter removal 3 weeks after operation.Leakage of urine was not recorded during 6 months following-up.Conclusion：The urethrovaginal fistula had various caus- es ,different surgical repair methods demonstrated benign results.

关 键 词：尿道憩室 尿道阴道瘘 

分 类 号：R713[医药卫生—妇产科学]