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尿流改道术式繁多,但迄今尚无一种堪称满意的术式。乳头式结肠膀胱直肠吻合术,对防止尿液从直肠返流和高氯血症两方面均有良好的治疗效果,现结合一例复杂尿瘘病人的尿流改道术,将这一手术方法报告如下。病例及手术方法患者,女,31岁,因膀胱尿道阴道瘘、尿道闭锁、阴道狭窄,于1982年10月11日行尿瘘修补、尿道成形术。术中见阴道疤痕累累,阴道内正常粘膜很少。虽经切开耻骨骨膜并以双侧大阴唇海绵体脂肪垫作为屏障,终因缺少膀胱筋膜和阴道筋膜二层的缝合,加之阴道粘膜血运不佳,手术失败。于1982年12月29日在连续硬膜外麻醉下改行乳头式膀胱直肠吻合术。
Urinary diversion surgery many, but so far there is no satisfactory surgery. Papillary colorectal anastomosis, to prevent the urine from rectal reflux and hyperchloremic both have good therapeutic effect, is now combined with a case of urinary tract diversion of patients with complex urinary fistula, the surgical method is reported as follows. Case and surgical methods Patients, female, 31 years old, bladder vesicourethral vaginal fistula, urethral atresia, vaginal stenosis, on October 11, 1982 urinary fistula repair, urethroplasty. Vaginal scar surgery see intravaginal mucosa rarely. Although the percutaneous dissection of the pubic periosteal and bilateral labia majora fat pad as a barrier, the end result of the lack of bladder fascia and vaginal fascia second floor suture, combined with vaginal mucosal poor blood supply, failed surgery. December 29, 1982 under continuous epidural anesthesia to divert nipple bladder anastomosis.