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目的:报告1例罕见女性膀胱臀部瘘和复习相关文献,探讨膀胱臀部瘘发病原因、形成机制及治疗原则。方法:患者18年前开始出现右臀部软组织反复感染后臀部漏尿,当地医院先后多次手术治疗无效。后转来我院行膀胱臀部瘘瘘管切除+膀胱壁无张力修补术,膀胱臀部瘘消失,3个月后复查膀胱镜、尿道造影及尿流率检查。结果:患者术后3个月复查膀胱镜见膀胱修补处黏膜连续完整、光滑红润,未见瘘口样改变,尿道排泄造影示膀胱充盈好,未见造影剂外渗,尿流率检查示最大尿流率35ml/s,膀胱容量305ml,随访至今尿瘘无复发。结论:膀胱臀部瘘非常罕见的,病因多较复杂,采用瘘管、周围瘢痕切除和膀胱壁分层无张力修补可取得了满意的治疗效果。
OBJECTIVE: To report a case of rare female bladder hip fistula and review the related literature to explore the causes, formation mechanism and treatment principle of bladder hip fistula. Methods: The patient started to have leakage of buttocks after repeated infection of soft tissue of the right hip 18 years ago. Many local surgeries were ineffective. After transfer to our hospital bladder hip fistula fistula resection + bladder tension-free repair, bladder hip fistula disappeared, 3 months after the review cystoscopy, urethral angiography and urinary flow rate examination. Results: The cystoscopy at 3 months postoperatively showed that the mucosa of the bladder repair site was continuous, smooth and ruddy, and no fistula-like changes were found. The urethral evacuation showed that the bladder was well filled with no extravasation of contrast agent and the urine flow rate examination showed the largest Urine flow rate 35ml / s, bladder capacity 305ml, no recurrence of urinary fistula ever since. CONCLUSIONS: Bladder hysterosal fistula is very rare and the etiology is more complex. Satisfactory curative effect can be achieved by using fistula, scar removal around the wall and stratification of the bladder wall without tension.