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摘要: 本文报道一例先天性阴道下段闭锁伴膀胱阴道瘘, 从临床症状、检查、诊断和处理方法等方面介绍该病特点, 并通过文献回顾加深临床医师对此类泌尿生殖系统畸形的认识。当青春期后出现周期性血尿而无阴道月经出血时, 应怀疑阴道闭锁合并先天性膀胱阴道瘘的可能。影像学检查和膀胱镜是重要的辅助诊断手段。手术切开闭锁的阴道、引流积血并修补瘘道是唯一的治疗手段。Abstract: We reported one patient with rare malformation, congenital lower vaginal atresia with vesico-vaginal fistula, and introduced the characteristics of this case encompassing clinical symptoms, examinations, diagnosis and management. Meanwhile, we reviewed previously reported similar cases to help clinical physicians better understand urogenital system malformation. When periodic hematuria without vaginal menstrual bleeding occurs in puberty, congenital vaginal atresia with vesico-vaginal fistula should be suspected. Imaging examinations and cystoscopy are important adjuvant diagnostic methods. The only treatment of this disease is surgical incision of the vaginal atresia for drainage and repair of the fistula tract.
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Key words:
- congenital vaginal atresia /
- vesico-vaginal fistula /
- hematuria
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[1] Zhu L, Wong F, Lang J. Atlas of surgical correction of female genital malformation[M]. Dordrecht:Springer Science, 2015:174-182. [2] 中华医学会妇产科分会.女性生殖器官畸形诊治的中国专家共识[J].中华妇产科杂志, 2015, 50:729-733. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhfck201510003 [3] 冷金花, 郎景和, 连利娟, 等.阴道闭锁16例临床分析[J].中华妇产科杂志, 2002, 37:217-219. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhfck200204009 [4] 中华医学会妇产科分会.关于女性生殖器官畸形统一命名和定义的中国专家共识[J].中华妇产科杂志, 2015, 50:648-651. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhfck201509002 [5] Chin AI, Rutman M, Raz S.Transverse vaginal septum with congenital vesical-vaginal communication and cyclical hematuria[J].Urology, 2007, 69:575-577. http://europepmc.org/abstract/MED/17382175 [6] Tancer ML.Observations on prevention and management of vesicovaginal fistula after total hysterectomy[J].Surg Gynecol Obstet, 1992, 175:501-506. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=WK_LWW2017052520389847 [7] Youssef AF.Menouria following lower segment cesarean section:a syndrome[J].Am J Obstet Gynecol, 1957, 73:759-767. doi: 10.1016/0002-9378(57)90384-8 [8] Verhoeven AT.Primary menoruia due to congenital vesicovaginalfistula[J].Obstet Gynecol, 1973, 41:515-520. http://www.ncbi.nlm.nih.gov/pubmed/4696968 [9] Zeineddine HA, Nassif J, El-Hout Y, et al.Congenital vesicovaginal fistula:spontaneous or forced? Two cases and literature review[J].Int Urogy necol J, 2014, 25:1167-1172. doi: 10.1007/s00192-014-2477-8 [10] Liu Y, Wang YF.Successful vaginal delivery at term after vaginal reconstruction with labium minus flaps in a patient with vaginal atresia:a rare case report[J].J Obstel Gynaecol Res, 2017, 43:1217-1221. doi: 10.1111/jog.13342 [11] Singh O, Gupta SS, Mathur RK. Urogenital fistulas in women 5-year experience at a single center[J].Urol J, 2010, 7:35-39. http://www.ncbi.nlm.nih.gov/pubmed/20209454 -
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