Abdominal uterine fistula surgery

Genitourinary spasm, including fecal fistula, urinary fistula and uterine abdominal wall spasm, is a genitourinary organ injury disease, which refers to an abnormal passage between the reproductive tract and its adjacent organs. There are many causes of genital mutilation. The main causes of childbirth injury, gynecological surgery injury, followed by upper pessary, upper ring, genital cancer radiotherapy and genital cancer in the late stage of collapse. With the development of medical science and technology, the improvement of maternal and child health care and the improvement of people's quality, genitourinary organs have gradually decreased in developed countries. However, in some countries and regions of the third world, due to economic backwardness, poor medical technology, and imperfect maternal and child health care, the incidence of such diseases is still rising, affecting the rise and fall of the country, the prosperity of the nation, and affecting women. Physical and mental health and even life. China is a developing country, and the rural population is the overwhelming majority. If we do not do a good job in preventive work, especially maternal health care, it will have an impact on improving the quality of the nation and the prosperity of the country, as well as affecting the health of women. It is imperative to do a good job in maternal health care. Hilton P, Ward A retrospectively analyzed 715 patients with genital warts in the southeastern part of Nigeria during the 25 years (1970.1-1994.12). 92.2% of patients were obstetric factors, of which 6.9% were due to cesarean section. Domestic reports of cockroaches occurring at the time of production are around 90%. The uterine abdominal wall is a kind of genital genital warts, often caused by infection after iatrogenic injury, and is a serious complication after cesarean section. Because the vagina itself has a bacterial cavity, potential pathogens or non-pathogenic bacteria may cause postoperative endogenous infections, and cesarean section can cause exogenous infections, even during cesarean section or Postoperative dilatation of the cervix may also cause ascending infection. Postoperative fistula is easy to form when the operation of suppurative adjunctural inflammation is incomplete or when inflammatory adhesion occurs after cesarean section. The main lesions of the uterine abdominal wall are uterine incision muscle wall infection, tissue necrosis, the whole incision is split, the uterine cavity content flows into the abdominal cavity, causing peritonitis, abdominal wall incision infection, forming an inflammatory channel between the uterus incision and the abdominal wall incision. Not healed. The patient's symptoms are after the operation (mainly cesarean section) 2 ~ 40d or so abdominal wall incision pain, redness, rupture, pus, prolonged unhealed, the formation of abdominal wall incision fistula and so on. Diagnosis: Inject 200 ml of methylene blue dilution into the abdominal wall, see blue liquid outflow in the cervix; or inject iodized oil from the abdominal wall fistula, put a probe indication in the uterine cavity, see the abdominal incision fistula is strip-like, like Some of the contrast agent enters the uterus, and then the iodized oil is injected through the uterus. The uterus is double-angled, the fallopian tube is not developed, and no obvious contrast agent leads to the fistula, which can be diagnosed as abdominal wall uterine fistula. The uterine abdominal wall is mainly treated with surgery, and there are reports of successful non-surgical treatment. Xue Chaojun successfully treated the abdominal wall with uterine fistula with traditional Chinese medicine. Wang Yanyuan and Xie Yuzhu treated the uterine abdominal wall with 20% berberine solution. Zhang Zhuoyu reported that 2 cases were cured by non-surgical treatment of uterine abdominal wall. Treatment of diseases: abdominal aortic vena cava Indication 1. The uterine abdominal wall is not an acute infection period. 2. Non-surgical treatment failure. Contraindications 1. Acute infection period. 2. Heart, lung and kidney dysfunction. Preoperative preparation 1. Anti-infective treatment. 2. Drainage of the ventral wall of the uterus is thorough. 3. Strengthen supportive care. 4. Prepare for total uterine resection. Surgical procedure 1. Incision: The skin around the fistula is cut into a longitudinal spine shape, and the edge of the incision is reversed, and several needles are intermittently sutured to close the opening of the pupil. Note that without damaging the fistula, the subcutaneous tissue and the fat layer around it are cut open to reach the muscle sheath. Preferably, the upper and lower parts of the spine-shaped incision include the old knife edge and the full length of the old scar until the rectus abdominis anterior sheath. . 2. With the fistula as the center, the muscle sheath is spun-shaped and the muscle sheath-spinning incision is extended upward and downward, and the abdomen is opened above or below the fistula. If the laparotomy cannot be performed under the pupil, only the upper laparotomy is performed, and the adhesion around the separation fistula is performed from the reverse side of the anterior abdominal wall. 3. The size of the fistula can be reached after the uterus is reached. If the fistula is not large, the fistula can be removed to repair the uterus. If the fistula is large, the uterus should be removed when there is no uterus left after the fistula is removed. 4. After the fistula is removed and sutured, the peritoneal defect should be repaired if it is large. If it cannot be repaired, the omentum should be covered to prevent re-adhesion. 5. If the stripping range is large or may be polluted, drain the tube if necessary.

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