宫内节育器异位致输尿管阴道瘘的临床诊疗并文献复习

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Clinical diagnosis and treatment of ureterovaginal fistula caused by intrauterine device displacement and a review of literature

ABUDUSAIMAITI Aili1 ，HALIMULATI Tusong² （1.Department of Urology，Xinhua Hospital， Yili Kazakh Autonomous Prefecture 8350oo； 2.Department of Urology，The First Affiliated Hospital of Xinjiang Medical University，Urumqi 83oooo，China）

ABSTRACT：ObjectiveTo explore the diagnosis and treatmentof ureterovaginal fistula caused by intrauterine device （IUD）ectopia，soas to provide reference for the diagnosis and managementof this condition.MethodsAretrospective analysis was conductedonthesymptoms，signsexaminationresults，andtreatmentofapatient with ureterovaginalfistuladueto IUD ectopia.The relevant literature wasreviewed.ResultsThe 41-year-old female presented with vaginal urinary leakage for more thanl month.After admission ⋅ preoperative preparations were completed，and ureterovaginal fistula was confirmed with computed tomography（CT）and intravenous pyelography（IVP）．After laparotomy was performed to remove the IUD， the patient was discharged after good recovery.Half a year after surgery，a telephonefollw-upshowed the patient had no subjective discomfort.Analysis of5reported casesof urinary leakage caused by IUDectopia revealed that the main cause was long-termchronic inflammatorystimulationbytheIUD.Among them，3cases werecured withsurgicalremovalof the IUDand fistula esection；of theother2cases，l refused surgical treatmentandlunderwent transvaginal fistula repair.Conclusion Ureterovaginalfistula caused byIUDectopia is ararecomplication.Earlydiagnosis requiresfamiliarity with itsetiologyand combinationof examinatios such asultrasound，IVP，and CT.Earlydiagnosis and treatmentcan prevent severecomplications.

KEY WORDS ：intrauterine device ectopic；ureterovaginal fistula；urinary leakage摘要：目的探讨宫内节育器异位致输尿管阴道瘘的诊断及治疗，为该类疾病的诊疗提供参考。（剩余7099字）