腟内異物による膀胱腟瘻

VESICOVAGINAL FISTULA ASSOCIATED WITH VAGINAL FOREIGN BODY : A CASE REPORT

　症例は帝王切開の既往をもつ26歳女性。頻尿を主訴に受診。急性膀胱炎の診断にて抗菌化学療法を施行したが治癒せず。膀胱鏡および逆行性膀胱造影にて，ヘアースプレー缶の円筒状キャップの一部が後方より膀胱三角部を穿通し，膀胱腟瘻の形成が確認された。受診1か月前，自慰目的にヘアスプレー缶を腟内に挿入後，腟内ではずれたキャップを放置していたことが判明した。経腹的膀胱腟瘻閉鎖術を施行し，幸い一期的に治癒しえた。

A 26-year-old woman with a history of Caesarean sec-tion consulted our department complaining of pollakisur-ia. A tentative diagnosis was acute cystits but oral antibiotic chemotherapy was ineffective despite adminis-tration of sensitive medicines. Cystoscopy and retrograde cystography demonstrated a portion of a spray cap which stuck through the vesical trigone, and the diagnosis of vesicovaginal fistula was confirmed. Later, the patient confessed that the cap had been neglected in the vagina since she manipulated the hair spray bottle for the purpose of masturbation one month prior to her initial consultation.