Abdominal repair

1. High bladder vaginal fistula. 2. The pupil is located in the triangle of the bladder. Treatment of diseases: bladder spasm Indication 1. High bladder vaginal fistula. 2. The pupil is located in the triangle of the bladder. Contraindications There are serious obstacles to the coagulation mechanism. High blood pressure, diabetes, and some bleeding-prone diseases. Preoperative preparation Clean the vagina and use intestinal antibiotics 3 days before surgery. Surgical procedure 1. Incision: a median longitudinal incision or an arcuate incision in the lower abdomen. 2. Exposure of the pupil: When the pupil is near the entrance of the ureter in the trigone of the bladder, a ureteral catheter can be inserted to define the ureteral bladder wall and reveal the pupil. When the pupil is near the ureteral entrance in the trigone of the bladder, a ureteral catheter can be inserted to determine the position of the ureter and avoid injury. At the bladder wall at the left and right edges of the pupil, each needle is sewn with a needle thread for easy traction. 3. Separation of the pupil: the bladder wall was cut along the edge of the pupil, and the sneak separation was made between the bladder wall and the vaginal wall, about 2 cm from the edge of the pupil. 4. Cut the pupil: Cut the scar tissue along the edge of the pupil. 5. Stitching the vaginal wall: suture the vaginal wall with a longitudinally full layer of absorbable lines. 6. Suture the bladder wall at the fistula: suture the bladder muscle layer and mucosa with two layers of transversely interrupted sutures. 7. Stitching the bladder incision: the incision of the bladder wall is made of absorbable lines, intermittent or continuous double suture, the first layer is sutured in the whole layer, and the second layer is reinforced. 8. Bladder internal catheter: Before closing the bladder wall incision, a double lumen catheter is placed in the bladder and is drawn from the lower abdominal wall. A drainage strip is placed on both sides of the bladder. complication Leakage treatment: If urine leakage is found 2 to 8 days after operation, the patient will be placed in the lateral position without the pupil, anti-inflammatory treatment, keep the urethra unobstructed, prolong the indwelling catheter to 18 to 20 days, some patients leak The urine can fade away.