膀胱阴道瘘的围手术期处理及手术技巧（附62例报告）

Perioperative management and surgical techniques of vesicovaginal fistula (62 cases)

摘要:

摘要：目的 总结膀胱阴道瘘（VVF）的围手术期处理及手术技巧。方法 回顾性分析2010年1月－2017年11月该院泌尿外科收治的62例VVF患者的临床资料。术前均通过膀胱镜检查和膀胱亚甲蓝实验以及相关的影像学检查确诊。手术方式采用耻骨上经膀胱修补术、经阴道修补术、腹腔镜下修补术及最近开展的机器人辅助腹腔镜下修补术。结果 62例患者术后随访1个月～2年60例治愈，在2例失败的患者中，1例经留置导尿管保守治疗后自愈。结论 术前明确诊断、进行充分的术前准备、选择合适的手术修补时期、注意术中精细分离和缝合技巧是提高修补手术成功率的关键。

Abstract:

Abstract: Objective To summarize the perioperative management and surgical techniques of vesicovaginal fistula (VVF). Methods A retrospective analysis was made on the diagnosis, surgical methods and therapeutic effects of 62 patients with VVF admitted in the department of urology in our hospital from January 2010 to November 2017. Preoperative diagnosis was confirmed by cystoscopy, methylene blue test and imaging examination. Surgical methods include suprapubic transvesical repair, transvaginal repair, laparoscopic repair and robotic-assisted laparoscopic repair. Results Among the 62 patients followed up from 1 month to 2 years, 60 cases cured, and 2 cases failed, of which 1 case self-healed after conservative treatment of indwelling catheter. Conclusions Preoperative diagnosis, adequate preoperative preparation, appropriate surgical repair period, fine separation and suture techniques are the keys to improve the success of the repair operation.