scholarly journals Vesicovaginal Fistula Post Caesarean Hysterectomy

2020 ◽  
Vol 15 (1) ◽  
pp. 84-85
Author(s):  
Manisha Maharjan ◽  
Aruna Karki ◽  
Ganesh Dangal ◽  
Hema Pradhan ◽  
Ranjana Shrestha ◽  
...  
Keyword(s):  
Methylene Blue ◽  
Genital Tract ◽  
Vesicovaginal Fistula ◽  
Obstetric Care ◽  
Developed Countries ◽  
Vaginal Route ◽  
Cesarean Hysterectomy ◽  
Genitourinary Fistula ◽  
Urinary Leakage ◽  
Caesarean Hysterectomy

Genitourinary fistula is an abnormal communication between the urinary tract and genital tract, most common being the vesicovaginal fistula. In most of the cases fistula results mainly due to poor obstetric care in developing countries, where as in developed countries most of the urogenital fistulas are iatrogenic. It is mainly diagnosed by clinical examinations and intravesical dye test using methylene blue. Repair can be done via abdominal or vaginal route based on the findings. Here we present a case of 27 years postnatal mother referred to our centre with diagnosis of vesicovaginal fistula post cesarean hysterectomy that was repaired successfully via vaginal approach. Keywords: cesaerean hysterectomy, urinary leakage, vesicovaginal fistula

scholarly journals Controversies in the Management of Endometrial Carcinoma: An Update

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Mohamed K. Mehasseb ◽  
John A. Latimer
Keyword(s):  
Radiation Therapy ◽  
Endometrial Cancer ◽  
Early Detection ◽  
Endometrial Carcinoma ◽  
Genital Tract ◽  
Female Genital Tract ◽  
Developed Countries ◽  
Changing Roles ◽  
The Developed Countries ◽  
Female Genital

Endometrial carcinoma is the commonest type of female genital tract malignancy in the developed countries. Endometrial carcinoma is usually confined to the uterus at the time of diagnosis and as such usually carries an excellent prognosis with high curability. Our understanding and management of endometrial cancer have continuously developed. Current controversies focus on screening and early detection, the extent of nodal surgery, and the changing roles of radiation therapy and chemotherapy and will be discussed in this paper.

scholarly journals Pregnancy Outcomes and Associated Factors for Uterine Rupture: An 8 Years Population-based Retrospective Study

2021 ◽  
Author(s):  
Sheng Wan ◽  
Mengnan Yang ◽  
Jindan Pei ◽  
Xiaobo Zhao ◽  
Chenchen Zhou ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Uterine Rupture ◽  
Obstetric Care ◽  
Developed Countries ◽  
Population Based ◽  
Fetal Heart Rate Monitoring ◽  
Fetal Complications ◽  
History Of ◽  
Scarred Uterus ◽  
Obstetrical Emergency

Abstract Background: Uterine rupture is an obstetrical emergency with serious undesired complications for laboring mothers resulting in fatal maternal and neonatal outcomes. The aim of this study was to assess the incidence of uterine rupture, its association with previous uterine surgery and vaginal birth after caesarean section (VBAC), and the maternal and perinatal implications. Methods: This is a population-based retrospective study. All pregnant women treated for ruptured uterus in one center between 2013 and 2020 were included. Their information retrieved from the medical records department were retrospectively reviewed.Results: A total of 209,112 deliveries were included and 41 cases of uterine rupture were identified. The incidence of uterine rupture was 1.96/10 000 births. 16 (39.0%) had maternal and fetal complications. There were no maternal deaths secondary to uterine rupture, while perinatal fatality related to uterine rupture was 7.3%. Among all case, 38 (92.7%) were scarred uterus and 3 (7.3%) were unscarred uterus. The most common cause of uterine rupture was previous cesarean section, while cases with a history of laparoscopic myomectomy were more likely to have serious adverse outcome. 24 (59%) of the ruptures occurred in anterior lower uterine segment. Fetal heart rate monitoring changes were the most reliable signs for rupture.Conclusions: Incidence of uterine rupture in the study area was consistent with developed countries. Further improvement in obstetric care and strong collaboration with referring health facilities was needed to ensure maternal and perinatal safety.

scholarly journals Successful Outcome of Pregnancy with Large Fibroid Uterus- A Case Report

2013 ◽  
Vol 25 (2) ◽  
pp. 87-89
Author(s):  
Nahreen Akhtar ◽  
Sayeeda Sultana ◽  
Fahmida Zabin
Keyword(s):  
Fetal Movement ◽  
Reproductive Age ◽  
Successful Outcome ◽  
Severe Bleeding ◽  
Age Group ◽  
Cesarean Hysterectomy ◽  
Fibroid Uterus ◽  
Life Threatening ◽  
Caesarean Hysterectomy ◽  
Reproductive Age Group

Background: Fibroid is the most common of all pelvic tumours, being present in 20 percent of  women in the reproductive age group and increases with age.Obstetric cesarean hysterectomy  is mostly done for indications deemed to be serious and life threatening to the patient and not  amenable to conservative management.Case: A 27 years old lady was admitted in BSMMU with 3rd gravida 35 wks pregnancy with  less fetal movement with fibroid uterus. Fibroid was diagnosed at her 21 weeks pregnancy by  ultrasonogram. Caesarean section was done at 35+ weeks of pregnancy because of nonreactive  CTG. After delivery of the baby and placenta, severe bleeding started. Caesarean hysterectomy  was done. The mother and baby were healthy at the time of discharge.Conclusion: Very few patients needed cesarean hysterectomy in case of fibroids in pregnancy. However there is no question that cesarean hysterectomy save lives especially in case of  bleeding that cannot be controlled by simpler measures. DOI: http://dx.doi.org/10.3329/bjog.v25i2.13746 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(2) : 87-89  

scholarly journals Evaluation of hysterectomy in a tertiary care hospital of central India: a retroprospective study

2021 ◽  
Author(s):  
Anchala Mahilange
Keyword(s):  
Tertiary Care ◽  
Operating Time ◽  
Central India ◽  
Laparoscopic Hysterectomy ◽  
Developed Countries ◽  
Abdominal Hysterectomy ◽  
Care Hospital ◽  
Age Group ◽  
Vaginal Route ◽  
Average Hospital

Background: Hysterectomy is the most common gynaecological surgical procedure after caesarean section. In India there is lower rate (4-6%) of hysterectomy has been reported, while there is higher frequency of hysterectomy (10-20%) in developed countries. Currently there are three main types of hysterectomy operations in practice for benign diseases abdominal hysterectomy, vaginal hysterectomy and laparoscopic hysterectomy. Abdominal hysterectomy remains the predominant method of uterus removal. The present study was planned t to analyse changes in the trends of hysterectomy from past 3 year in the study area.Methods: The present observational study was conducted in department of obstetrics and gynaecology and associated Dr. B.R.A.M. hospital Raipur (CG), India. Data was collected retrospectively from January 2009 to May 2012 from hospital medical records. Prospectively data was obtained from patient and his file from June 2013 to September 2014. Data was compiled in MS-excel and checked for its completeness and correctness, and then it was analyzed by using suitable software.Results: Total no of hysterectomy conducted in study duration was 1000. Study showed declining trend of hysterectomy in our institute. Most common age group of hysterectomy was 41-50 year. which 45.8% followed by age group 31-40 that is 32.5%. Most common indication of hysterectomy was fibroid uterus 33.6% followed by prolapse uterus 29.5%. 29% cases were operated via vaginal route for descent of uterus and 21% cases operated by vaginal route for non-descent uterus.50% cases were operated via abdominal route. Average operating time for TAH was 1.43±0.50, for VH was 1.08±0.03. Average hospital stay for TAH was 8.87±3.31 and VH was 5.27±1.07. Conclusions: In our study it had been seen that rate of hysterectomy is in decreasing trend as more conservative approach is now preferred. To minimize most of complications of hysterectomy second opinion fresh eyes and multi-disciplinary approach is recommend in all patients undergoing this procedure.

scholarly journals Robot-Assisted Infratrigonal Vesicovaginal Fistula Repair

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
João Pádua Manzano ◽  
Fábio da Silva Crochik ◽  
Felipe Guimarães Pugliesi ◽  
Renato Vasconcelos Souza de Almeida ◽  
Petronio Augusto de Souza Melo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Vesicovaginal Fistula ◽  
Fistula Repair ◽  
Robot Assisted ◽  
Disease Treatment ◽  
Case Presentation ◽  
Genitourinary Fistula ◽  
Vesicovaginal Fistulas

Background. Although relatively rare, vesicovaginal fistula is the most common genitourinary fistula, causing a significant decrease in patients’ quality of life. Location of fistula is major supratrigonal, with some cases located in the trigone and rarely below it. Disease treatment is surgical, and repair can be performed by several techniques, including robot-assisted. Case Presentation. We present a case of a patient who developed an infratrigonal vesicovaginal fistula after treatment of a cervical cancer. The patient was submitted to robotic repair of the vesicovaginal fistula. Conclusion. The use of robot-assisted laparoscopy is expanding over all areas of urology and its applicability to repair vesicovaginal fistulas brings good results.

Variable Outcome in Quintuplets Pregnancy Based on Obstetric Care

2011 ◽  
Vol 14 (6) ◽  
pp. 580-585
Author(s):  
Grzegorz H. Bręborowicz ◽  
Anna Dera ◽  
Marta Szymankiewicz ◽  
Mariola Ropacka-Lesiak ◽  
Wiesław Markwitz
Keyword(s):  
Medical Center ◽  
Tertiary Care ◽  
Obstetric Care ◽  
Bed Rest ◽  
Well Being ◽  
Developed Countries ◽  
Population Based ◽  
Premature Delivery ◽  
Fetal Reduction ◽  
Gestation Time

The incidence of multiple pregnancies has increased dramatically over the last few years in developed countries, largely attributed to delayed childbearing and the increasing use of assisted reproduction technologies and ovulation inducing hormones. Relatively few countries have population-based statistics covering birth statistics. Of those that do, the numbers of quintuplet pregnancies rose sharply in the nineties while, at the same time, their delivery rates decreased greatly because of the use of fetal reduction. Fetal reduction is not possible or legal in some countries, Poland being one of them, and therefore obstetricians are faced with the challenges of quintuplet deliveries. Conservative treatment and management is difficult, and outcomes often vary greatly. Despite this, expert care provided at tertiary care centers can positively influence outcomes. The objective of this article is to present different care options and their consequences in two illustrative cases, as well as to establish a set of obstetric care and management goals that would allow prolongation of the gestation time. Quintuplet pregnancy is rare but poses relevant clinical problems to both the obstetrician and the neonatologist. It should be managed with close cooperation between all concerned. Due to the extreme and invariable risk of premature delivery associated with quintuplet pregnancies, we recommend early diagnosis, adequate prenatal care at one tertiary medical center, routine hospitalization and bed rest, repeated ante partum ultrasound surveillance with tests of fetal well-being, tocolytic therapy at first signs of the risk of premature labor, and specialized neonatology care after delivery.

scholarly journals Approaches to Female Congenital Genital Tract Anomalies and Complications

2017 ◽  
Vol 102 (7-8) ◽  
pp. 367-376
Author(s):  
Emine Ince ◽  
Pelin Oğuzkurt ◽  
Semire Serin Ezer ◽  
Abdülkerim Temiz ◽  
Hasan Özkan Gezer ◽  
...  
Keyword(s):  
Genital Tract ◽  
Vesicovaginal Fistula ◽  
Treatment Strategies ◽  
Surgical Approaches ◽  
Renal Anomaly ◽  
Imperforate Hymen ◽  
Surgical Interventions ◽  
Unicornuate Uterus ◽  
Wide Range ◽  
Transvesical Approach

Objective: Female congenital genital tract anomalies may appear with quite confusing and deceptive complications. This study aims to evaluate the difficulties in diagnosis and treatment of female congenital genital tract anomalies that frequently present with complications. Summary: During a 10-year period, we evaluated 20 female patients with congenital genital tract anomalies aged between 3 days and 16 years. All patients were retrospectively analyzed in terms of the results of diagnostic studies, surgical intervention, and treatment. Methods: Ultrasonography and magnetic resonance imaging revealed hydromucocolpos or hematocolpometra, imperforate hymen, distal vaginal atresia, didelphys uterus, an obstructed right hemivagina, uterovaginal atresia, a unicornuate uterus with a noncommunicating rudimentary horn, a vesicovaginal fistula, a utero-rectal fistula, intraabdominal collection, and a vaginal calculus. Results: Two patients had Mayer-Rokitansky-Küster-Hauser syndrome and 6 patients had obstructed hemivagina and ipsilateral renal anomaly syndrome. Definitive surgical interventions were hymenotomy, vaginal pull-through, vaginovaginostomy, and vesicovaginal fistula repair using a transvesical approach. In conclusion, female congenital genital tract anomalies may appear with a wide range of complications. Conclusions: There is a potential to do significant harm, if the patient's anatomic problems are not understood using detailed imaging. Revealing the anatomy completely and defining the complications that have already developed are critical to tailor the optimal treatment strategies and surgical approaches.

scholarly journals Iatrogenic Genitourinary Fistula: A Rising Trend

2017 ◽  
Vol 32 (1) ◽  
pp. 10-13
Author(s):  
Taufiqua Hussain ◽  
Afrina Begum ◽  
Nasrin Akhter ◽  
Tabassum Ghani ◽  
- Noorjahan ◽  
...  
Keyword(s):  
Physical Examination ◽  
Prospective Study ◽  
Developing Country ◽  
Recent Issue ◽  
Vaginal Route ◽  
Detailed History ◽  
Iatrogenic Injuries ◽  
Genitourinary Fistula ◽  
History Of ◽  
Day By Day

Background:Obstetric fistula (OF) is not very uncommon in our country. But recent issue of increase in iatrogenic fistula (IF) creates a field of interest. Objective:To find out the frequency and the cause of iatrogenic genitourinary fistula admitted in National Fistula Centre (NFC), Dhaka. Methods:This prospective study was conducted in NFC, Dhaka from January, 2010 to December, 2012. All cases admitted during the study period were included in this study. All patients were evaluated through detailed history, physical examination, relevant investigations and examination under anaesthesia (EUA). Repair was done through abdominal or vaginal route based on the findings. Results of repair were noted and analyzed. Results:On an average more than 20% cases of genitourinary fistula (GUF) were due to iatrogenic causes. Among them about 90% cases had history of hysterectomy as an offending procedure. A rising trend of iatrogenic fistula is observed with 19.04% in 2010, 15.68% in 2011 and 30% in 2012. Conclusion:This study shows that iatrogenic injuries in women under 40 years of age form major share in the aetiology of GUF. Iatrogenic fistula are increasing day by day. It is the time to check the experience of surgeons doing the gynecological and obstetrical surgeries in a developing country like ours. Bangladesh J Obstet Gynaecol, 2017; Vol. 32(1): 10-13

scholarly journals Iatrogenic Genitourinary Fistula: Changing Trends

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
T Pradhan ◽  
A Agrawal ◽  
MC Regmi
Keyword(s):  
Decision Making ◽  
Retrospective Study ◽  
Work Environment ◽  
Vesicovaginal Fistula ◽  
Emergency Caesarean Section ◽  
Fistula Repair ◽  
Genitourinary Fistula ◽  
Changing Trends ◽  
Increasing Trend ◽  
History Of

Aims: To study the frequency of iatrogenic cause amongst the surgery done for genitourinary fistula and to study the type and cause of iatrogenic genitourinary fistula. Methods: This is a 5 year retrospective study analyses 73 iatrogenic fistulas from 217 women undergoing surgery for genitourinary fistula repair from year 2013 to 2018 on going. The analysis considers frequency and characteristics of type of fistula. Results: Out of 217 genitourinary fistula 73(33.6%) were iatrogenic. Vaginal vault fistulas were 54.7% followed by ureteric fistula 32.8%, vesicovaginal fistula 10.9% and there were 2 iatrogenic RVF. The frequency of surgeries for iatrogenic fistula were found to be in increasing trend towards current years and 83.5% of the iatrogenic fistula were found with history of hysterectomy followed by emergency caesarean section 16.4%.  Conclusions: Women undergoing hysterectomy were under risk for iatrogenic fistula. Optimum work environment is important to reduce surgical error during procedures. Operating training should be emphasized on optimal surgical skills, decision making.

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