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.

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 A CLINICAL CASE OF REMOVING A RESIDUAL FOREIGN BODY FROM THE LEFT SUPRACLAVICULAR REGION

2017 ◽  
Vol 4 (3) ◽  
pp. 120-122
Author(s):  
V.V. Boyko ◽  
V.V. Makarov ◽  
A.L. Sochnieva ◽  
V.V. Kritsak
Keyword(s):  
Surgical Treatment ◽  
Foreign Body ◽  
Soft Tissue ◽  
Clinical Case ◽  
Foreign Bodies ◽  
Soft Tissues ◽  
Life Quality ◽  
The Other ◽  
Practical Case ◽  
The One

Boyko V.V., Makarov V.V., Sochnieva A.L., Kritsak V.V.Residual foreign bodies in soft tissues are one of the main causes of chronical infection lesions and decrease in life quality. Surgical treatment is the most common way to relieve the patient from a foreign body. Often there is a question whether to remove a foreign body? On the one hand, all foreign bodies that are in the human body must be removed. On the other hand, in the absence of symptoms, the risk of surgery performed for the purpose of removal exceeds the risk associated with finding the foreign body. We would like to describe a practical case of removing a foreign body (Kirschner`s wires) from the left supraclavicular region. The young patient lived with a fragment of Kirschner's wire left after the osteosynthesis of the fractured clavicle for 5 years. Surgery to remove the residual foreign body was successful. On the 7th postoperative day the patient was discharged from the hospital under the supervision of surgeons at the place of residence.Key words: foreign body in soft tissue, Kirschner`s wire, surgical treatment. КЛІНІЧНИЙ ВИПАДОК ВИДАЛЕННЯ ЗАЛИШКОВ СТОРОННЬОГО ТІЛА З ЛІВОЇ НАДКЛЮЧИЧНОЇ ОБЛАСТІБойко В.В., Макаров В.В., Сочнева А.Л.,  Крицак В.В.Залишкові чужорідні тіла м'яких тканин залишаються однією з основних причин виникнення вогнища хронічної інфекції та зниження рівня якості життя. Хірургічне лікування основний спосіб позбавити хворого від наявності чужорідного агента. Часто виникає питання чи видаляти чужорідне тіло. З одного боку, усі сторонні тіла, що знаходяться в тілі людини, підлягають видаленню, з іншого боку при відсутності симптомів ризик операції, проводимої з метою видалення, перевищує ризик, пов'язаний з перебуванням чужорідного тіла. Ми хотіли б поділитися випадком видалення залишкового стороннього тіла (спиці Кіршнера) лівої надключичної ділянки із власної практики. Молода пацієнтка прожила з уламком спиці Кіршнера, залишеної після металлоостеосинтезу поламаної ключиці протягом 5 років. Операція з видалення залишкового стороннього тіла пройшла успішно. На 7 післяопераційну добу пацієнтка була виписана зі стаціонару під спостереження хірурги за місцем проживання.Ключові слова: чужорідне тіло м'яких тканин, спиця Кіршнера, хірургічне лікування. кЛИНИЧЕСКИЙ СЛУЧАЙ УДАЛЕНИЯ ОСТАТКОВ ИНОРОДНОГО ТЕЛА ИЗ ЛЕВОЙ ПОДКЛЮЧИЧНОЙ ОБЛАСТИ Бойко В.В., Макаров В.В., Сочнева А.Л.,  Крицак В.В.Остаточные инородные тела мягких тканей остаются одной из основных причин возникновения очага хронической инфекции и снижения уровня качества жизни. Хирургическое лечение основной способ избавить больного от наличия чужеродного агента. Часто возникает вопрос удалять ли инородное тело? С одной стороны, все инородные тела, находящиеся в теле человека, подлежат удалению, с другой стороны при отсутствии симптомов риск операции, производимой с целью удаления, превышает риск, связанный с нахождением инородного тела. Мы хотели бы поделится случаем удаления остаточного инородного тела (спицы Киршнера) левой надключичной области из собственной практики. Молодая пациентка прожила с обломком спицы Киршнера, оставленной после металлоостеосинтеза поломанной ключицы в течении 5 лет. Операция по удалению остаточного инородного тела прошла успешно. На 7 послеоперационные сутки пациентка была выписана из стационара под наблюдение хирурги по месту жительства.Ключевые слова: инородное тело мягких тканей, спица Киршнера, оперативное лечение.

scholarly journals VENOUS CONDUITS IN CORONARY SURGERY: OLD PROBLEMS — NEW SOLUTIONS

2019 ◽  
Vol 34 (1) ◽  
pp. 24-32
Author(s):  
Y. Y. Vecherskiy ◽  
D. V. Manvelyan ◽  
V. V. Zatolokin ◽  
V. M. Shipulin
Keyword(s):  
Coronary Artery ◽  
Soft Tissues ◽  
The Other ◽  
Wound Complications ◽  
Coronary Surgery ◽  
Surgical Revascularization ◽  
Other Hand ◽  
Venous Shunt ◽  
High Incidence

The introduction of autovenous coronary artery bypass grafting (CABG) marked the era of surgical revascularization in patients with coronary artery disease. It provided effective treatment for angina and significantly improved the long-term prognosis. Venous transplants today remain the most popular conduits in coronary surgery due to their availability, ease of harvesting, and the absence of length restrictions. Despite the advantages of autovenous CABG, the main disadvantage is the high incidence of venous graft failure, which represents an important and unresolved problem in cardiac and cardiovascular surgery. On the other hand, the traditional allocation of a large saphenous vein implies the dissection of soft tissues throughout the length of the isolated conduit. Traumatic dissection causes a long-lasting persistent pain syndrome after surgery, frequent abnormalities in  skin sensitivity, and a high incidence of wound complications in the lower extremities. These complications lengthen the period of rehabilitation of patients and worsen the quality of life. There is an approach of isolating the vein in a block with surrounding tissues to optimize the long-term functioning of the venous shunt, however, this technique is even more traumatic than the traditional method, and therefore its use is limited in practice. On the other hand, the introduction of minimally invasive methods of isolation allowed to reduce the incidence of wound complications and to improve the cosmetic result, but there is no convincing data regarding the effect on the consistency of shunts in the long-term postoperative period. The problems associated with the use of venous conduits in CABG are multifaceted, and their solutions are necessary to improve the effectiveness of surgical revascularization.

scholarly journals A Conservative Approach to a Peripheral Ameloblastoma

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Rocco Borrello ◽  
Elia Bettio ◽  
Christian Bacci ◽  
Marialuisa Valente ◽  
Stefano Sivolella ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Soft Tissues ◽  
Complete Removal ◽  
The Other ◽  
Conservative Approach ◽  
Choice Of Treatment ◽  
Long Term Follow Up ◽  
One Year

Peripheral Ameloblastoma (PA) is the rarest variant of ameloblastoma. It differs from the other subtypes of ameloblastoma in its localization: it arises in the soft tissues of the oral cavity coating the tooth bearing bones. Generally, it manifests nonaggressive behavior and it can be treated with complete removal by local conservative excision. In this study we report a case of PA of the maxilla in a 78-year-old female patient and we describe the four different histopathological patterns revealed by histological examination. After local excision and diagnosis, we planned a long term follow-up: in one year no recurrence had been reported. The choice of treatment is illustrated in Discussion.

Behavioural observations on the scavenging fauna of the Patagonian slope

1999 ◽  
Vol 79 (6) ◽  
pp. 963-970 ◽  
Author(s):  
Martin A. Collins ◽  
Cynthia Yau ◽  
Conor P. Nolan ◽  
Phil M. Bagley ◽  
Imants G. Priede
Keyword(s):  
Soft Tissues ◽  
Deep Ocean ◽  
Rapid Response ◽  
The Other ◽  
Falkland Islands ◽  
Antimora Rostrata ◽  
Consumption Rates ◽  
Patagonian Toothfish ◽  
Primary Consumers ◽  
Dissostichus Eleginoides

The scavenging fauna of the Patagonian slope (900–1750 m), east of the Falkland Islands was investigated using the Aberdeen University Deep Ocean Submersible (AUDOS), an autonomous baited camera vehicle designed to photograph scavenging fish and invertebrates. The AUDOS was deployed on ten occasions in Falkland waters. Nine experiments were of 10–14 h duration and baited with 800 g of squid and one experiment lasted six days, baited with a 10 kg toothfish (Dissostichus eleginoides). Analysis of photographs revealed considerable patchiness in the composition of the scavenging fauna. Hagfish (Myxine cf. fernholmi) dominated three of the shallower experiments including the 6-d experiment, arriving quickly from down-current, holding station at the bait and consuming the soft tissues first, with consumption rates of up to 200 g h−1. In the other experiments, stone crabs (Lithodidae), the blue-hake (Antimora rostrata) and amphipods were the primary consumers, but the rate of bait consumption was lower. Patagonian toothfish (D. eleginoides) were attracted to the bait at each experiment, but did not attempt to consume the bait. The patchiness in the fauna may be a result of depth, substratum and topography, but in general the rapid response of the scavenging fauna indicates that carrion is rapidly dispersed, with little impact on the local sediment community.

Bladder Problems

2013 ◽  
Author(s):  
J. Eric Ahlskog
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Neurogenic Bladder ◽  
Soft Tissues ◽  
Bladder Wall ◽  
Bladder Function ◽  
System Control ◽  
Autonomic Nervous ◽  
Age Related ◽  
The Central Nervous System

Urinary problems occur with normal aging. In women they often relate to the changes in female anatomy due to the delivering of babies. With superimposed age-related changes in soft tissues, laxity may result in incontinence (loss of urinary control), especially with coughing, laughing, or straining. In men the opposite symptom tends to occur: urinary hesitancy (inability to evacuate the bladder). This is due to constriction of the bladder outlet by an enlarging prostate; the prostate normally surrounds the urethra, through which urine passes. DLB and PDD are often associated with additional bladder problems. Recall that the autonomic nervous system regulates bladder function and that this system tends to malfunction in Lewy disorders. Hence, reduced bladder control is frequent among those with DLB, PDD, and Parkinson’s disease. This condition is termed neurogenic bladder, which implies that the autonomic nervous system control of bladder reflexes is not working properly. This may manifest as urgency with incontinence or hesitancy. Neurogenic bladder problems require different strategies than those used for treating the simple age-related problems that develop in mid-life and beyond. Moreover, there are certain caveats to treatment once a neurogenic bladder is recognized. The bladder is simply a reservoir that holds urine. It is located in the lower pelvis and is distant from the kidneys. The kidneys essentially filter the circulating blood and make the urine. The urine flows down from the kidneys into the bladder, as shown in Figure 14.1. Normally, as the bladder slowly fills with urine, a reflex is triggered when it is nearly full. This results in conscious awareness of the need to urinate, plus it primes the reflexive tendency of the bladder to contract in order to expel the urinary contents. The bladder is able to contract because of muscles in the bladder walls. Normally, nerves activate these muscles at the appropriate time, which forcefully squeeze the bladder, expelling the urine. Nerve sensors in the bladder wall are activated by bladder filling and transmit this information to the central nervous system, ramping up bladder wall muscle activity.

scholarly journals Magnetoconvection Patterns in Rotating Convection Zones

1991 ◽  
Vol 130 ◽  
pp. 37-56
Author(s):  
Paul H. Roberts
Keyword(s):  
Convection Zone ◽  
Solar Surface ◽  
Giant Cells ◽  
Conclusive Evidence ◽  
The Other ◽  
The Sun ◽  
Solar Convection Zone ◽  
Solar Convection ◽  
Entire Thickness ◽  
Convective Motions

AbstractIn addition to the well-known granulation and supergranulation of the solar convection zone (the “SCZ”), the presence of so-called “giant cells” has been postulated. These are supposed span the entire thickness of the SCZ and to stretch from pole to pole in a sequence of elongated cells like a “cartridge belt” or a bunch of “bananas” strung uniformly round the Sun. Conclusive evidence for the existence of such giant cells is still lacking, despite strenuous observational efforts to find them. After analyses of sunspot motion, Ribes and others believe that convective motions near the solar surface occurs in a pattern that is the antithesis of the cartridge belt: a system of “toroidal” or “doughnut” cells, girdling the Sun in a sequence that extends from one pole to the other. Galloway, Jones and Roberts have recently tried to meet the resulting theoretical challenge, with the mixed success reported in this paper.

Development of Anisotropy in Fibroblast Populated Collagen Gels

2002 ◽  
Author(s):  
Stavros Thomopoulos ◽  
Vedran Knezevic ◽  
Kevin D. Costa ◽  
Jeffrey W. Holmes
Keyword(s):  
Mechanical Properties ◽  
Soft Tissues ◽  
Mechanical Load ◽  
The Other ◽  
Collagen Structure ◽  
Collagen Gels ◽  
Specific Loading ◽  
Anisotropic Mechanical Properties ◽  
Muscle Loading ◽  
Heart Wall

The development of anisotropic mechanical properties is critical for the successful tissue engineering of many soft tissues. Load bearing tissues naturally develop varying degrees of anisotropy, presumably in response to their specific loading environment. For example, the heart wall develops a collagen structure that varies in a predictable manner through its depth [1]. Tendon, on the other hand, develops a matrix that does not vary much in orientation and is highly aligned in the direction of muscle loading [2]. These varied levels of anisotropy may be due to inherent differences between the cells in each tissue, to differences in the mechanical load and boundary conditions seen by the cells, or to a combination of these factors.

A Structural Continuum Constitutive Model for a Two-Phase Soft Tissue

2010 ◽  
Author(s):  
Silvia Wognum ◽  
Michael S. Sacks
Keyword(s):  
Mechanical Behavior ◽  
Soft Tissues ◽  
Bladder Wall ◽  
Constitutive Models ◽  
Tissue Level ◽  
Model Parameters ◽  
Two Phase ◽  
Tissue Properties ◽  
Highly Nonlinear ◽  
Cord Injury

Due to the complexity in determining multi-constituent tissue properties, most structural constitutive models for soft tissues focus on a single constituent. However, many tissues contain multiple load-bearing constituents, such as collagen fibers and smooth muscle (SM) cells. Moreover, to elucidate how observed changes in tissue components are related to altered net mechanical behavior at the tissue level, structural constitutive models require physiological relevant model parameters and formulations for changes in referential configuration when one component is physically removed. As an excellent example application that underscores these issues, we have examined the urinary bladder wall (UBW), which undergoes large deformations and exhibits highly nonlinear and anisotropic mechanical behavior [1,2]. Moreover, it undergoes profound remodeling in response to different pathologies such as spinal cord injury (SCI) [1,2].

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