Martius labial-rotation flapで修復した尿道腟瘻の2例

Abstract

医原性尿道腟瘻の2例に対し, Martius labial-rotation flapを用いた瘻孔閉鎖術を行った。症例1は48歳女性で, 傍尿道腺膿瘍のため膿瘍切開を受けた。症例2は33歳女性で, 妊娠中, 腟前壁静脈瘤から多量に出血し, 腟前壁静脈瘤切除術を受けた。術後, 2例とも持続する尿失禁を認め, 尿道鏡, 尿道造影で尿道腟瘻と診断された。大陰唇の皮下組織でMartius labial-rotation flapを作成し, 尿道腟瘻を閉鎖した。術後, 2例とも, 尿失禁などの症状は認められなかった。尿道腟瘻に対し, Martius labial-rotation flapを用いた瘻孔閉鎖術は有効であると思われた。

Urethrovaginal fistulas are rare. In case 1, a 48-year-old woman had undergone transvaginal drainage for an paraurethral abscess. In case 2, a 33-year-old woman had undergone resection of vaginal varicocele with massive bleeding during pregnancy. Postoperatively both patients complained of total incontinence. Urethroscopy and urethrography revealed an urethrovaginal fistula in each case. Repair ofurethrovaginal fistula using Martius labial-rotation flap was performed and the fistula was closed in both cases. We concluded that repair of urethrovaginal fistula using Martius labial-rotation flap may be useful for patients with urethrovaginal fistula.