rectovesical fistula resection

Rectal bladder fistula resection is one of the surgical procedures for the removal of fistula after surgery for rectal bladder disease. Treatment of diseases: bladder spasm Indication 1. Non-surgical treatment of low rectal bladder fistula that does not heal for 3 months. 2. Tuberculous bladder spasm, no systemic active tuberculosis. Contraindications 1, with systemic diseases, can not tolerate surgery. 2, local infection, not suitable for surgery. Preoperative preparation 1. Patients with acute infection should control the symptoms, and take a bath with 1:5000 potassium permanganate warm water, until the acute inflammation subsides before surgery. 2. Tuberculous rectal bladder fistula, 2 weeks before surgery, anti-tuberculosis drugs were used, the patient had no symptoms of tuberculosis poisoning, and the erythrocyte sedimentation rate was normal before surgery. 3. Enter the fluid diet 1 day before surgery. 4. Enema with soapy water 2 to 3 hours before surgery. Surgical procedure 1. If there are multiple external or internal mouths, first insert gauze into the rectal bladder fistula, and inject the blue from the earliest appearance of the medical history to observe the position of each internal mouth. 2. Using the probe to probe the earliest fistula, cut it and cut it whole, and then explore the outer or inner mouth of each branch one by one, all of which can be cut, but not necessarily all removed, resulting in postoperative scar stenosis . 3. If some fistulas are located above the shallow group of the anal sphincter, or have multiple internal openings, they should not be cut temporarily. First, use black thick thread to pass through these fistulas, loosening and knotting one by one for the mark, after the shallow wound is healed. , and then divided the operation, open the deep fistula by all. This method can avoid the incontinence of the rectal bladder sphincter in the deep and shallow groups at the same time, or cut off two or more anal sphincters at one time.

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