篇名 | Fistula Involving Urinary Bladder:Experience with the Management of 23 Cases |
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卷期 | 12:3 |
作者 | Meng, En 、 Chuang, Feng-pin 、 Wu, Sheng-tang 、 Lee, Shang-sen 、 Sun, Guang-huan 、 Chen, Hong-I 、 Chang, Sun-yran 、 Ma, Cheng-ping 、 Yu, Dah-shyong |
頁次 | 121-124 |
關鍵字 | fistula involving urinary bladder 、 fecaluria 、 urinary leakage 、 cystoscopy 、 TSCI |
出刊日期 | 200109 |
PURPOSE: Fistula involving urinary bladder is a common disease caused by pelvic malignancies,radiotherapy, previous operations, primary intestinal diseases and trauma. We have reviewed our experience in diagnosis and management of 23 cases of fistulae involving urinary bladder MATERIALS AND METHODS: From 1995 to 2000, 23 patients with fistulae involving urinary bladder were diagnosed and treated at the Tri-Service General Hospital. Each patient’s records were reviewed retrospectively regarding symptoms, causes, primary disease processes, diagnostic studies, managements, complications, mortality and follow-up.Results: The most common fistula involving urinary bladder was vesicointestinal fistula (57%),followed by vesicovaginal (26%) and vesicocutaneous (17%) fistulae. Fecaluria (46%) was the most common symptom of vesicointestinal fistula,while the major cause of vesicointestinal fistula was malignancy (54%). Urinary leakage from the vagina (100%) was a major symptom found in the patients of vesicovaginal fistula, which was caused by malignancy (33%), previous operation (33%) and radiotherapy (33%). Previous operation (75%) was found to be a major cause for vesicocutaneous fistula. Most of the fistulae involving urinary bladder may be diagnosed by cystoscopy (83%). The treatment and outcome were individualized, dependent on patient’s general condition and progression of the disease.
CONCLUSIONS: The diagnosis of fistula involving urinary bladder can be established by combining the results of cystoscopy, colposcopy, lower G-I series and cystography. Two-stage operation is preferable to single-stage operation in the case of vesicointestinal fistula, while a single-stage operation is recommended for the vesicovaginal and vesicocutaneous fistulae.