侵蝕至陰道與膀胱的恥骨陰道懸吊帶合併卡於膀胱陰道廔管的
懸吊帶結石 - 一個罕見的病例報告
廖奕安、鄭詠庭、黃國皓、張宏江
國立台灣大學附設醫院 泌尿部
Pubovaginal sling erosion to vagina and bladder complicated with sling stone in vesicovaginal fistula – a very rare case report
Yi-An Liao、Yung-Ting Cheng、Kuo-How Huang、Hong-Chiang Chang
Department of Urology、National Taiwan University Hospital
Abstract
Introduction:
Pubovaginal sling erosion to vagina and bladder complicated with sling stone is very rare. According to our search of literature, several cases about bladder stone in vesicovaginal fistula and vaginal stone formation secondary to mesh were reported, but combination of this two situations were not yet reported. Such situation may cause several complications, including, hydronephrosis and urinary tract infection.
Case presentation:
A case of a 69-year-old woman with history of pubovaginal sling and CCRT of cervical cancer presented with a >1-year history of urinary leakage and lower abdominal for the past few months. An ultrasound scan showed left side hydronephrosis. An intravenous urography showed left lower ureteral stricture with obstructive uropathy and huge bladder stone (Figure 1A). Computed tomography revealed a 4.6cm stone at the vesicovaginal space and a suspected large cystovaginal fistula (Figure 1B). Direct vision to vagina showed a huge vaginal stone about 5 cm at vesicovaginal space, which was crushed by lithotripsy (Figure 1C), revealing previous mesh buried tightly inside (Figure 1D). Cystoscopy through urethra showed a huge defect at vesicovaginal septum. The patient discharged afterwards with no more lower abdominal pain.