scholarly journals Closure of large vesicovaginal fistulas by transplantation of the bladder wall

2020 ◽  
Vol 6 (4) ◽  
pp. 422-423
Author(s):  
A. Brandt
Keyword(s):  
Urinary Bladder ◽  
Pelvic Floor ◽  
Bladder Wall ◽  
Vaginal Wall ◽  
Vesicovaginal Fistulas

With large defects in the bottom of the urinary bladder, extensive adhesions of the edges of the fistulas directly with the bony walls of the pelvic floor, or with fixation of the uterus posteriorly, resp. to the sides, as well as in the absence of the anterior lip of the vaginal part or the lower part of the uterus with an existing utero-cystic fistula, it is possible to use the Trendelenburg method to close the defects, transplant a flap from the opposite fistula of the vaginal wall, or release the bladder over a large extent from surrounding parts and apply for transplantation of the wall of the urinary bladder itself.

scholarly journals Evaluation and management of obstetric genital fistulas treated at a pelvic floor centre in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christl Reisenauer ◽  
Bastian Amend ◽  
Claudius Falch ◽  
Harald Abele ◽  
Sara Yvonne Brucker ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Developed Countries ◽  
Vaginal Wall ◽  
Fistula Closure ◽  
Fistula Repair ◽  
Anterior Position ◽  
Multiparous Women ◽  
Uncommon Condition ◽  
Rectovaginal Fistulas ◽  
Vesicovaginal Fistulas

Abstract Background Obstetric genital fistulas are an uncommon condition in developed countries. We evaluated their causes and management in women treated at a German pelvic floor centre. Methods Women who had undergone surgery for obstetric genital fistulas between January 2006 and June 2020 were identified, and their records were reviewed retrospectively. Results Eleven out of 40 women presented with genitourinary fistulas, and 29 suffered from rectovaginal fistulas. In our cohort, genitourinary fistulas were more common in multiparous women (9/11), and rectovaginal fistulas were more common in primiparous women (24/29). The majority of the genitourinary fistulas were at a high anterior position in the vagina, and all rectovaginal fistulas were at a low posterior position. While all genitourinary fistulas were successfully closed, rectovaginal fistula closure was achieved in 88.65% of cases. Women who suffered from rectovaginal fistulas and were at high risk of recurrence or postoperative functional discomfort and desired another child, we recommended fistula repair in the context of a subsequent delivery. For the first time, pregnancy-related changes in the vaginal wall were used to optimize the success rate of fistula closure. Conclusions In developed countries, birth itself can lead to injury-related genital fistulas. As fistula repair lacks evidence-based guidance, management must be tailored to the underlying pathology and the surgeon’s experience. Attention should be directed towards preventive obstetric practice and adequate perinatal and postpartum care. Although vesicovaginal fistulas occur rarely, in case of urinary incontinence after delivery, attention should be paid to the patient, and a vesicovaginal fistula should be ruled out. Trial registration Retrospectively registered, DRKS 00022543, 28.07.2020.

scholarly journals Evaluation and management of obstetric genital fistulas treated at a pelvic floor centre in Germany

2020 ◽  
Author(s):  
Christl Reisenauer ◽  
Bastian Amend ◽  
Claudius Falch ◽  
Harald Abele ◽  
Sara Yvonne Brucker ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Developed Countries ◽  
Vaginal Wall ◽  
Fistula Closure ◽  
Fistula Repair ◽  
Anterior Position ◽  
Uncommon Condition ◽  
Rectovaginal Fistulas ◽  
Vesicovaginal Fistulas ◽  
First Time

Abstract Background: Obstetric genital fistulas are an uncommon condition in developed countries. We evaluated their causes and management in women treated at a German pelvic floor centre.Methods: Women who had undergone surgery for obstetric genital fistulas between January 2006 and June 2020 were identified and their records were reviewed retrospectively.Results: 11 out of 40 women presented with genitourinary fistulas, and 29 suffered from rectovaginal fistulas. In our cohort the genitourinary fistulas were more common in multiparous (9/11) and the rectovaginal fistulas in primiparaous women (24/29). The majority of the genitourinary fistulas were at a high anterior position in the vagina and all rectovaginal fistulas were at a low posterior position. While all genitourinary fistulas were successfully closed, rectovaginal fistula closure was achieved in 88.65%. Women who suffered from rectovaginal fistulas and were at high risk of recurrence or postoperative functional discomfort and desired another child, we recommended the fistula repair in context of a subsequent delivery. For the first time, pregnancy related changes of the vaginal wall were used to optimize the success rate of a fistula closure.Conclusions: In developed countries, the birth itself can lead to injury-related genital fistulas. As fistula repair lacks evidence-based guidance, their management has to be tailored to the underlying pathology and the surgeonʼs experience. Attention should be directed towards preventive obstetric practice and adequate perinatal and postpartum care. Even if vesicovaginal fistulas occur rarely, in case of urinary incontinence after delivery, attention should be paid to the patient and a vesicovaginal fistula should be ruled out.Trial registration: retrospectively registered, DRKS 00022543, 28.07.2020

scholarly journals Evaluation and management of obstetric genital fistulas treated at a pelvic floor centre in Germany

2020 ◽  
Author(s):  
Christl Reisenauer ◽  
Bastian Amend ◽  
Claudius Falch ◽  
Harald Abele ◽  
Sara Yvonne Brucker ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Developed Countries ◽  
Vaginal Wall ◽  
Fistula Repair ◽  
Anterior Position ◽  
Multiparous Women ◽  
Uncommon Condition ◽  
Rectovaginal Fistulas ◽  
Vesicovaginal Fistulas ◽  
First Time

Abstract BackgroundObstetric genital fistulas are an uncommon condition in developed countries. We evaluated their causes and management in women treated at a German pelvic floor centre.MethodsWomen who had undergone surgery for obstetric genital fistulas between January 2006 and June 2020 were identified, and their records were reviewed retrospectively.ResultsEleven out of 40 women presented with genitourinary fistulas, and 29 suffered from rectovaginal fistulas. In our cohort, genitourinary fistulas were more common in multiparous women (9/11), and rectovaginal fistulas were more common in primiparous women (24/29). The majority of the genitourinary fistulas were at a high anterior position in the vagina, and all rectovaginal fistulas were at a low posterior position. While all genitourinary fistulas were successfully closed, rectovaginal fistula closure was achieved in 88.65% of cases. For women with rectovaginal fistulas and were at high risk of recurrence or postoperative functional discomfort and desired another child, we recommended fistula repair in the context of a subsequent delivery. For the first time, pregnancy-related changes in the vaginal wall were used to optimize the success rate of fistula closure.ConclusionsIn developed countries, birth itself can lead to injury-related genital fistulas. As fistula repair lacks evidence-based guidance, management must be tailored to the underlying pathology and the surgeon’s experience. Attention should be directed towards preventive obstetric practice and adequate perinatal and postpartum care. Although vesicovaginal fistulas occur rarely, in case of urinary incontinence after delivery, attention should be paid to the patient, and a vesicovaginal fistula should be ruled out.Trial registrationretrospectively registered, DRKS 00022543, 28.07.2020

Method of lateral suturing of large vesicovaginal fistulas

1929 ◽  
Vol 25 (2) ◽  
pp. 234-235
Author(s):  
I. Tsimkhes
Keyword(s):  
Soft Tissues ◽  
Direct Action ◽  
Bladder Wall ◽  
Side Wall ◽  
Suture Line ◽  
Vaginal Wall ◽  
The Other ◽  
Cystic Wall ◽  
Entire Thickness ◽  
Vesicovaginal Fistulas

Since the main reason for failures with plastic methods is the direct action of urine on the suture line, Dr. side, up and to the side, where urine cannot reach with a catheter demeure. The technique is briefly as follows: there is no need to stretch the cervix, you can successfully operate in depth. The edges of the fistula are cut obliquely throughout. Then, capturing the refreshed edge of one side of the vaginal wall with the coher, the entire thickness of the vaginal wall is separated from the entire thickness of the bladder wall to the exposure of the soft tissues of the thigh. The same is done on the other side. As a result, 4 mobilized flaps are obtained, each of which consists separately of the cystic and separately of the vaginal wall, separated from each other. Both refreshed edges of the cystic wall are sutured to the soft tissues of the thigh. After the cystic walls are sewn to the side wall, the vaginal wall is sutured.

Possibilities of using neodymium laser (Nd:YAG) in patients with concomitant diseases which are accompanied by pathological discharge from the genital tract

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. 75-81
Author(s):  
Olga A. Pauzina ◽  
Inna A. Apolikhina ◽  
Darya A. Malyshkina
Keyword(s):  
Drug Therapy ◽  
Pelvic Floor ◽  
Genital Tract ◽  
Vaginal Discharge ◽  
Muscle Tone ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Dysfunction ◽  
Vaginal Wall ◽  
Neodymium Laser ◽  
Frequent Relapses

Background. Pathological vaginal discharge is the most common disorder in women after giving birth who have vaginal relaxation syndrome and vaginal wall prolapse, as well as in women during menopause. To date, there are no clear treatment regimens for mixed vulvovaginal infections, and the use of only drug therapy in patients with pelvic organ prolapse and genitourinary syndrome of menopause in combination with diseases which are accompanied by pathological vaginal discharge does not give a long lasting result and is characterized by frequent relapses. In this regard, the use of laser methods in combination with drug therapy may lead to the recovery of vaginal microbiocenosis and a decrease in the number of relapses of diseases which are accompanied by pathological discharge from the genital tract. Results. Description. This article presents a clinical case and description of the experience of using a neodymium laser for the treatment of a patient with recurrent mixed vulvovaginitis, 2nd- degree vaginal wall prolapse, loss of pelvic floor muscle tone, vaginal relaxation syndrome and sexual dysfunction using neodymium laser. The woman received 3 procedures of exposure to a neodymium laser with an interval of 2830 days. After 3 procedures of exposure to a neodymium laser, the patient has a good clinical efficacy in the recovery of vaginal microbiocenosis. Conclusions. An innovative technique of exposure to Nd:YAG neodymium laser in the practice of a gynecologist has shown high clinical efficiency in the treatment of not only pelvic floor dysfunction, but also mixed vulvovaginitis. And, despite this aspect of the use of laser technologies requires further study, we can use a neodymium laser in combination with traditional drug therapy to treat diseases which are accompanied by pathological discharge from the genital tract in cases of ineffective drug monotherapy and frequent relapses.

Alloplastic Replacement of the Urinary Bladder Wall with Lyophilized Human Dura

1970 ◽  
Vol 2 (3) ◽  
pp. 195-202 ◽  
Author(s):  
A. Kelâmi ◽  
A. Lüdtke-Handjery ◽  
G. Korb ◽  
J. Rolle ◽  
J. Schnell ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Bladder Wall ◽  
Urinary Bladder Wall

scholarly journals Diagnostic considerations in urinary bladder wall calcification

1981 ◽  
Vol 136 (4) ◽  
pp. 791-797 ◽  
Author(s):  
HM Pollack ◽  
MP Banner ◽  
LO Martinez ◽  
CJ Hodson
Keyword(s):  
Urinary Bladder ◽  
Bladder Wall ◽  
Wall Calcification ◽  
Urinary Bladder Wall
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