球海绵体肌脂肪垫在复杂膀胱阴道瘘修补术中的应用:“围堰堵瘘”法

发布时间：2018-07-29 14:39

【摘要】：目的探讨双层缝合技术("围堰")及球海绵体肌脂肪垫移植("堵瘘")在复杂膀胱阴道瘘修补术中的应用价值。方法 2010年1月~2015年12月,采用双层缝合技术("围堰")及球海绵体肌脂肪垫移植("堵瘘")方法对6例复杂膀胱阴道瘘患者实施经阴道修复手术。4例瘘口1.5 cm。4例瘘口位置高(近输尿管口)。4例有修复失败史。经阴道瘘口插入尿管至膀胱并充盈水囊,显露并支撑瘘口,双层缝合膀胱关闭瘘口;球海绵体肌脂肪垫移植加强瘘口。术后留置尿管2周。结果 6例手术全部一次修复成功。术后平均随访28个月(3~60个月),均未发现漏尿。结论双层缝合技术("围堰")及球海绵体肌脂肪垫移植("堵瘘")处理复杂膀胱阴道瘘成功率高。
[Abstract]:Objective to investigate the application value of double suture technique (cofferdam) and bulbar cavernous muscle fat pad ("occluding fistula") in the repair of complex vesicovaginal fistula. Methods from January 2010 to December 2015, Double suture technique ("cofferdam") and bulbar cavernous muscle fat pad transplantation ("fistula") were used to repair 6 patients with complicated vesicovaginal fistula. The fistula was repaired by transvaginal repair in 4 patients (1.5 cm.4) with a high fistula position (near ureter orifice). 4 cases had a history of failure. The vaginal fistula was inserted into the bladder and filled with water sac, the fistula was exposed and supported, the fistula was closed by double suture, and the fistula was strengthened by the transplantation of bulbous cavernous muscle fat pad. Postoperative indwelling urethral catheter for 2 weeks. Results all 6 cases were repaired successfully at one time. The average follow-up was 28 months (3-60 months), and no leakage of urine was found. Conclusion double-layer suture (cofferdam) and bulbar cavernous muscle fat pad transplantation ("plugging fistula") have a high success rate in the treatment of complicated vesicovaginal fistula.
【作者单位】：深圳大学附属罗湖医院女性生殖道畸形诊疗中心妇科盆底专科;
【基金】：深圳市卫生计生委科技计划项目(201601055)
【分类号】：R699

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