子宮脱に対する腹式単純子宮摘除術ならびにポリプロピレンメッシュ(ガイネメッシュ)を用いた腹式仙骨膣固定術後に生じた膀胱膣瘻の1例

Abstract

A 45-year-old woman underwent abdominal simple hysterectomy and sacrocolpopexy with polypropylene mesh (GYNEMESH) for uterine prolapse at the department of Gynecology in October 2006. One month after the operation, she visited our department with a complaint of urinaryincontinence. Cystographyand magnetic resonance imaging revealed a vesicovaginal fistula. A foleycatheter was indwelt for the purpose of conservative treatment, but failed. Considering possible infection and inflammation remaining, we decided to perform abdominal repair of the vesicovaginal fistula about three months after the operation. Transabdominal repair of the vesicovaginal fistula was performed in February2007. During the operation, a fistula 3 mm in diameter was confirmed just adjacent to the distal edge of the polypropylene mesh which had been fixed between the bladder and the anterior wall of vagina. Eleven days after the operation, cystography revealed no evidence of the vesicovaginal fistula. There has been no sign of recurrence at three years after the operation.