膀胱陰道瘻管: 病例報告

李虹霈、李香瑩

高雄醫學大學附設中和紀念醫院 泌尿科

Vesicovaginal fistula: A Case Report

Hung-Pei Li、Hsiang-Ying Lee
Department of Anatomy, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Abstract:

Here we present a case of Vesicovaginal fistula initially manifested with urinary incontinence with a focus on its diagnosis and management.

A 71-year-old female with medical history of hypertension, bladder stone post cystolithotripsy in 2022 and with intrauterine device (IUD) for decades, presented with urinary incontinence for several months. She received medication treatment with Imipramine, Vesicare and Betmiga but there was little effect. Bladder diary disclosed small bladder capacity less than 100 ml and nocturnal polyuria. Urodynamic study revealed bladder hypersensitivity with small capacity and normal compliance. Under the impression of Overactive Bladder-Wet, bladder botulinum toxin injection was arranged. Cystoscopy showed a fistula at trigone and vaginal examination revealed vaginal lesion at anterior wall. Retrograde urography demonstrated contrast leakage from the bladder. The final diagnosis was Vesicovaginal fistula and Robotic-assisted Laparoscopic Vesicovaginal Fistula Repair was performed. The patient recovered uneventfully after the operation