【摘要】 目的:总结大阴唇球海绵体脂肪垫(Martius瓣)"屏障"及阴道壁"加固"技术在复杂尿道阴道瘘修复中的作用。方法:回顾2009年1月～2012年3月釆用Martius瓣"屏障"技术及阴道壁"加固"术修复复杂尿道阴道瘘7例。年龄12～35岁,平均22岁;产伤1例,车祸致下尿路生殖道损伤6例,瘘孔大小2.0～3.0cm;合并尿道狭窄2例、后尿道闭锁2例、阴道狭窄3例。探讨了补瘘与处理合并症时机,介绍了手术方法及术后处理。结果:7例全部1次修复成功,随访6～24个月。5例排尿通畅,最大尿流率12～20ml/s,2例后尿道闭锁者术后出现尿线变细,扩张一次后治愈。1例膀胱颈闭锁者术后有轻度压力性尿失禁。阴道狭窄者均满意康复。结论:Martius瓣"屏障"及阴道壁"加固"术可明显提高复杂尿道阴道瘘修复成功率。更多还原

【Abstract】 Objectives: To summarize the clinical efficacy of the use of "Martius flap barrier technique"(the labia majora bulbocavemosus fat pad)and the "vaginal wall reinforcement technique" in complicated urethrovaginal fistula repairs.Methods: From Jan 2009 to Mar 2012,our hospital admitted 7 patients with complicated urethrovaginal fistulas.The patients were repaired with the "Martius flap barrier" and "vaginal wall reinforcement" techniques.Their clinical data were retrospectively analyzed.Results: The fistula of all patients were successfully repaired.After 6-24 months’ follow-up,five cases have got easy and smooth urination with Qmax of 12-20ml/s.Two cases with posterior urethral atresia suffered from thin urination,but were cured after the urethra was dilated only once.One case with bladder neck atresia suffered from mild stress urinary incontinence after the operation.All the cases with vaginal stenosis have got fully recovered.Conclusions: The Martius flap barrier and the vaginal wall reinforcement techniques can significantly improve the success rate in repairing complicated urethrovaginal fistula.更多还原