膀胱阴道瘘后冷杯膀胱活检:小回顾。

Open Access Journal of Urology Pub Date : 2010-09-14 eCollection Date: 2010-01-01 DOI:10.2147/OAJU.S12181
Abigail Mawhinney, Ammar Hameed, Ali Thwaini, Colin Mulholland
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摘要

简介:我们报告一例膀胱阴道瘘(VVF)后冷杯活检;据我们所知,这是唯一报告的病例。我们介绍了临床病史/表现,调查和治疗的结果。子宫内膜瘘是妇科和产科手术中最令人痛苦的并发症之一。恶性肿瘤根治性手术和放疗后发生VVF的风险超过1%。在过去的十年中,这些瘘管的管理已经得到了更好的定义和标准化。方法与结果:1例低级别浅表性膀胱癌患者行膀胱肿瘤多次切除,初次切除后单次应用丝裂霉素,成功清除了膀胱癌,但膀胱体积小,结疤。此外,吸烟对组织完整性和愈合的影响由来已久。vfs非常罕见,是冷杯活检后令人不快的结果,增加了手术治疗的心理和社会影响。结论:尽管冷杯活检是住院医师和会诊医师的日常例行手术,但对于膀胱完整性缺陷和膀胱容量小的患者,应就如何治疗存在共识。文献报道的未放疗患者的瘘管修复成功率在70%到100%之间,阴道或腹部入路的结果相似,平均成功率分别为91%和97%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Vesico-vaginal fistula post cold cup bladder biopsy: mini review.

Introduction: We report a case of a vesico-vaginal fistula (VVF) post cold cup biopsy; to our knowledge this is the only reported case. We present the clinical history/presentation, investigation and the outcome of the treatment. VVFs are among the most distressing complications of gynecologic and obstetric procedures. The risk of developing a VVF is more than 1% after radical surgery and radiotherapy for malignancies. Management of these fistulas has been better defined and standardized over the last decade.

Methods and results: A case of low grade superficial bladder cancer was treated with multiple resections of bladder tumor and a single installation of mitomycin post initial resection which successfully cleared her bladder cancer, but nevertheless led to a small size and scarred bladder. In addition there was a long history of smoking with its effects on tissue integrity and healing. VVFs are very rare and are an unpleasant outcome post a cold cup biopsy, adding to the psychological and social effects of the surgical treatment.

Conclusion: Although cold cup biopsy is a normal day procedure performed by both residents and consultants, consensus should exist on how to treat a patient who has a bladder with defective integrity and small capacity. The rate of successful fistula repair reported in the literature varies between 70% and 100% in nonradiated patients, with similar results when a vaginal or abdominal approach is performed, the mean success rates being 91% and 97%, respectively.

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