超声造影诊断膀胱阴道瘘1例

Vesicovaginal Fistula Diagnosed by Contrast-Enhanced Ultrasound:A Case Report

膀胱阴道瘘(VVF)指因为膀胱与阴道之间存在异常的瘘道,导致尿液不受控制地从阴道流出,严重影响患者的身心健康、生活质量,及时准确地发现对于患者非常重要。常规经阴道超声对于膀胱与阴道之间瘘管较小者容易漏诊,超声造影能够更加清晰、准确地显示瘘道的位置、粗细。本文探讨分析了1例就诊于中国人民解放军总医院第一医学中心的宫颈癌、膀胱肿瘤术后患者,患者因尿失禁,持续经阴道漏尿伴遗尿来诊,常规经阴道超声因阴道中段及直肠局部狭窄,探头无法置入,考虑VVF可能,随即经超声造影检查明确提示VVF,后经膀胱镜确诊,患者未进行治疗,持续随访。此病例提示超声造影可更有效、更精确的诊断VVF,对精准诊断VVF提供重要参考价值。

Vesicovaginal fistula(VVF)refers to the uncontrolled flow of urine from the vagina due to an abnormal fistula between the bladder and the vagina,which seriously affects the physical and mental health and quality of life of the patient.Timely and accurate detection of the fistula is crucial.Routine transvaginal ultrasound is prone to missing the diagnosis of small fistulas between the bladder and the vagina.Contrast-enhanced ultrasound(CEUS)can more clearly and accurately display the location and thickness of fistulas.In this paper,we discussed and analyzed a case of postoperative cervical cancer and bladder tumor in the First Medical Center of the General Hospital of the People's Liberation Army.The patient presented with urinary incontinence and persistent transvaginal leakage with urine loss.Routine transvaginal ultrasound suggested the possibility of VVF due to localized stenosis in the mid-vagina and the rectum,which made it impossible to place the probe.The diagnosis of VVF was then clearly suggested by CEUS and confirmed by cystoscopy.The patient chose not to undergo treatment and was followed up continuously.This case suggests that CEUS can diagnose VVF more effectively and accurately,providing an important reference for the precise diagnosis of VVF.