Vesico-uterine fistula associated with secondary infertility: A case of successful repair

Genitourinary fistulas usually have devastating consequences on a woman's reproductive health. vesicouterine fistulae though uncommon variant of genitourinary fistula, are usually due to iatrogenic etiologies. The case reported was diagnosed after second caesarean section when she was being evaluated for secondary infertility. Keywords: Youseff 'syndrome, Amenorrhea, Caesarean Section, Fistula,

Download Full-text

Study of Influence on Infertility

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v1i2.127 ◽

1970 ◽

Vol 1 (2) ◽

Author(s):

Shi Huihui

Keyword(s):

Risk Factors ◽

Reproductive Health ◽

Incidence Rate ◽

Influential Factors ◽

Developmental Abnormality ◽

Secondary Infertility ◽

Child Bearing ◽

Related Risk ◽

Infertility Patients ◽

The City

For objective, analyzing the pathogenesis of infertility patients inÂ Zhengzhou and exploring the relevant influential factors. Method:Â selecting 264 infertility patients in our hospital and peripheralÂ hospitals in the city from March of 2015 to October of 2016 toÂ carry out relevant investigation & research so as to analyze theÂ major pathogeny and related risk factors of 264 infertility patients.Â For result, for infertility patients, the occurrence of infertility isÂ common in female whether it is primary or secondary. TheÂ primary infertility is usually caused by uterus factors, showing theÂ congenital developmental abnormality of uterus. However, theÂ primary cause of secondary infertility is tubal nowhere, commonlyÂ and mainly showing frequentÂ abortion frequency.As to maleÂ infertility, the idiopathic infertility is mainly related toÂ asthenospermia while the secondary infertility is mainly related toÂ asthenospermia andÂ oligospermia. Conclusion: clinically, there areÂ more causes of infertility. Thus, the reproductive health educationÂ and direction need to be strengthened and completed on the maleÂ and female during the child-bearing period, and the timely andÂ professional direction needs to be given to the patients with lowÂ incidence of infertility to diagnose and treat as early as possible soÂ as to lower the incidence rate of infertility, worthy of attention.

Download Full-text

Secondary infertility associated with a uterine niche after cesarean section

Voprosy ginekologii akušerstva i perinatologii ◽

10.20953/1726-1678-2020-5-95-101 ◽

2020 ◽

Vol 19 (5) ◽

pp. 95-101

Author(s):

M.A. Kurtser ◽

◽

N.M. Egikyan ◽

N.A. Savelyeva ◽

M.A. Vatagina ◽

...

Keyword(s):

Caesarean Section ◽

Cesarean Section ◽

Key Words ◽

Assisted Reproductive Technologies ◽

Embryo Implantation ◽

Reproductive Technologies ◽

Psychological Factor ◽

Secondary Infertility ◽

Embryo Survival ◽

Abdominal Delivery

The frequency of abdominal delivery remains high and does not tend to decrease. This may lead to an increase in the number of complications associated with cesarean section, such as uterine niche. Considering the fact that literature data on uterine form of secondary infertility in patients with niches is lacking, and taking into account our own experience and observations made during laparoscopic and hysteroscopic metroplasty, we believe that it is necessary to discuss hypothetical mechanisms underlying the effects of uterine niches on: (1) natural embryo implantation or during an IVF program; (2) embryo survival (embryotoxicity); (3) quality and survival of spermatozoa (spermatoxicity). It is also important to analyze the psychological factor that decreases fertility in these patients. Key words: infertility; assisted reproductive technologies; isthmocele; caesarean section; niche; fertility

Download Full-text

Residual urinary Incontinence after Successful Repair of Obstetric Fistula

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v30i2.30898 ◽

2016 ◽

Vol 30 (2) ◽

pp. 86-91

Author(s):

Fahmida Zabin ◽

Sayeba Akhter ◽

Musarrat Sultana

Keyword(s):

Risk Factors ◽

Obstetric Fistula ◽

Fistula Closure ◽

College Hospital ◽

Medical College ◽

Genitourinary Fistula ◽

Genital Fistula ◽

Successful Repair ◽

Structured Questionnaire

Objective(s): Aim of the study was to identify the risk factors in those women who remain with incontinence after successful fistula repair.Materials & method: The women admitted in Dhaka Medical College Hospital with obstetrical genitourinary fistula were the study population.A observational study was done with all women having successful repair. They were asked to return for a follow-up appointment, 3 months after discharge . Women were examined and questioned at discharge and at follow up appointment. A structured questionnaire were used and information entered into a database.Results: Women who returned for follow-up 3 month postsurgery were included in predictors of closure analyses. Small bladder size (ARR 3.7; 95% CI 1.211.8), severe scarring (ARR 1.2; 95% CI 1.12.7), urethral involvement (ARR 7.3; 95% CI 3.31.46), were predicted failed fistula closure. Women with a closed fistula at 3 month follow-up were included in predictors of residual incontinence analyses .Conclusion:The prognosis for genital fistula closure is related to preoperative bladder size, previous repair, vaginal scarring, and urethral involvement.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(2) : 86-91

Download Full-text

Prevalence and associated factors of infertility among 20–49 year old women in Henan Province, China

Reproductive Health ◽

10.1186/s12978-021-01298-2 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Shoujing Liang ◽

Yuanhui Chen ◽

Qian Wang ◽

Huanhuan Chen ◽

Chenchen Cui ◽

...

Keyword(s):

Reproductive Health ◽

Ovarian Reserve ◽

Associated Factors ◽

Henan Province ◽

Gynecological Surgery ◽

Childbearing Age ◽

Secondary Infertility ◽

Factors Associated ◽

Primary Infertility ◽

History Of

Abstract Background Infertility is a reproductive health problem which affects not only individuals, families and social populations. Recently, the infertility rate in China has a trend of increase year by year, and few studies have reported the infertility rate in Henan Province, China. The aim of this study was to investigate the current prevalence and associated factors of infertility among women of childbearing age in Henan Province, China. Methods This cross-sectional study was conducted from March 2019 to October 2019. We sampled 765 women who were 20–49 years old in eight hospitals of four cities in Henan Province, China. This survey included a questionnaire, physical examination, vaginal ultrasound examinations, and serum anti-Mullerian hormone (AMH) assessment, all of which were conducted under uniform standards by trained personnel. According to the data collected from questionnaire, participants were divided into infertile and fertile groups and analyzed associated factors. Results Among all the 765 participants in this study, the prevalence of infertility was 24.58%. The prevalence of primary infertility was 6.54%, and the prevalence of secondary infertility was 18.04%. In logistic multivariate regression analyses, infertility was associated with age (p < 0.001), history of gynecological surgery (p < 0.001), sweet food (p = 0.003) and decreased ovarian reserve (DOR) (p < 0.001). After further analyses, factors associated with primary infertility were age of marriage (p = 0.006), age of first sexual intercourse (p = 0.003), long-term air-conditioning environment (p < 0.001), decreased ovarian reserve (p = 0.005) and age (p = 0.002). And factors associated with secondary infertility were history of gynecological surgery (p < 0.001), decreased ovarian reserve (p = 0.002), waist-to-hip ratio (WHR) above 0.85 (p = 0.043), delivery times (p = 0.001) and ages (p < 0.001). Conclusion The prevalence of infertility among women aged 20–49 was 24.58% and only 61.17% infertile women sought medical help in Henan Province, China. Age, history of gynecological surgeries and DOR may increase the risk of infertility. Local public health departments and medical professionals need to discharge their duty of reducing the high incidence of infertility and protecting women’s reproductive health.

Download Full-text

Successful Treatment of Unexplained Secondary Infertility by Ayurveda- A Case Study

AYUSHDHARA ◽

10.47070/ayushdhara.v8i4.790 ◽

2021 ◽

pp. 3457-3460

Author(s):

Bhavsar Megha Nandkishor ◽

Mehere Seema Chandrakant

Keyword(s):

Oxidative Stress ◽

Reproductive Health ◽

Single Case ◽

Female Child ◽

Oocyte Quality ◽

Unhealthy Lifestyle ◽

Secondary Infertility ◽

Oral Medications ◽

Female Reproductive Health

Secondary infertility indicates previous pregnancy but failure to conceive subsequently. Incidences of secondary infertility are increasing day by day. Many factors like age, hectic schedule, stress, diet, unhealthy lifestyle are responsible for it. Psychological stress disturbs overall health of women by inducing generation of reactive oxygen species and thereby oxidative stress. This oxidative stress may hamper the health of ovaries, oocyte quality and causes female reproductive health disorders. Aim: To study the effect of Ayurvedic treatment in management of unexplained secondary infertility. Objective: To access the effect of Ayurvedic management of unexplained secondary infertility. Methodology: It is a single case study of unexplained secondary infertility. Case description: A 38 years old female Hindu patient came in YMT OPD of Streeroga and Prasutitantra anxious for child since 3 years. She had a history of 2 MTPs, one before and one after her 5 year old female child. Her last MTP was done in 2015. After that she was actively trying to conceive around last 3 years but couldn’t conceive again in spite of regular unprotected coitus. She was advised to do ovulation study and HSG but she was not willing to do investigations, but as per history, her schedule was very hectic and stressful treatment: She was advised Ayurvedic oral medications along with Panchkarma. Outcome: After four months of treatment she conceived. Conclusion: Ayurvedic management can act as an anti-stress and antioxidant agent thereby improving the reproductive health of women and increasing their chances of conception.

Download Full-text

Laparoscopic repair of the uterine scar defect – successful treatment of secondary infertility: a case report and literature review

Acta medica Lituanica ◽

10.6001/actamedica.v23i4.3424 ◽

2017 ◽

Vol 23 (4) ◽

pp. 227-321 ◽

Cited By ~ 2

Author(s):

Greta Bakavičiūtė ◽

Sabina Špiliauskaitė ◽

Audronė Meškauskienė ◽

Diana Ramašauskaitė

Keyword(s):

Caesarean Section ◽

Laparoscopic Repair ◽

Clinical Symptoms ◽

Previous History ◽

Diagnostic Methods ◽

Secondary Infertility ◽

Caesarean Scar ◽

Treatment Techniques ◽

History Of ◽

Uterine Scar

Background. The aim of this paper is to present a clinical case of laparoscopic repair of a uterine scar defect, to assess the effectiveness of treatment reviewing the latest literature sources, and to provide recommendations of uterine scar defect management. Materials and methods. We report the case of a 33-year-old woman with an insufficient uterine scar and one-year history of secondary infertility. Following this, she underwent corrective laparoscopic repair, successfully got pregnant two months later and carried pregnancy to full term. We discuss the prevalence of caesarean scar defects, their clinical symptoms, diagnostic methods, various treatment techniques, and their outcomes. Results and conclusion. Caesarean scar defects, insufficient uterine scars, isthmocele or scar dehiscence following a caesarean section involve myometrial discontinuity at the site of a scar previous caesarean section. These anatomical defects associated with prolonged menstrual bleeding, chronic pelvic pain, dysmenorrhea, dyspareunia and secondary infertility. Laparoscopic repair of the uterine scar defect is an effective method of treatment of secondary infertility. Patients with a previous history of caesarean section who present complaints of secondary infertility, need a detailed evaluation of the uterine scar before planning future pregnancies.

Download Full-text

Management of Vesicouterine Fistulae during "Fistulae Surgical Caravan" in Cote D'ivoire

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v13i2.21713 ◽

2018 ◽

Vol 13 (2) ◽

pp. 27-31

Author(s):

L.E. Djanhan ◽

J.M. Dia ◽

M.M. Menin ◽

B. Kouamé ◽

E. Bohoussou ◽

...

Keyword(s):

Caesarean Section ◽

Surgical Technique ◽

Rural Areas ◽

Average Duration ◽

Case Series ◽

Repair Rate ◽

Vesicouterine Fistulae ◽

Surgical History ◽

Scarred Uterus ◽

Urogenital Fistulae

Aims : To describe the epidemiological, clinical and therapeutic characteristics of patients treated for vesico-uterine fistula. Methods : This was a case series of 34 patients prospectively collected for descriptive purposes. They were treated for Vesico-uterine fistulae during "fistulas surgical caravans" from 1st January 2012 to 31st December 2016. Results :Vesico-uterine fistulae represented 2.1% of all treated urogenital fistulae. At the time of fistula occurrence, the average age of the patients was 33.3 years, and the majority were illiterate (88.2%), lived in rural areas and were unemployed (73.5%). All the fistulae were associated to childbirth, the majority of which took place on a scarred uterus (67.6%). And this childbirth responsible for the fistula was a delivery done by caesarean section in 97.7% of cases. Average duration of the fistula before management was 6 years. Finally, all the patients were operated by the same surgical technique, made by abdominal extra peritoneal transvesical way. The successful first repair rate was 97.1% in 33 patients. The only case of failure was successfully cured using surgical another technique in a second attempt. Conclusion: The vesicouterine fistulae were rare, were mostly associated to previous uterus surgical history and the successful rate is almost 100%.

Download Full-text

Characteristics and Surgical Success of Patients Presenting for Repair of Genitourinary Fistula in VVF Center of a Tertiary Hospital

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v31i1.34274 ◽

2017 ◽

Vol 31 (1) ◽

pp. 34-39

Author(s):

Rowshan Ara ◽

Abu Taher Mohammad Nurul Amin ◽

Md Shadiqul Hoque ◽

Setara Binte Kasem

Keyword(s):

Success Rate ◽

Gestational Age ◽

Surgical Repair ◽

Mode Of Delivery ◽

Tertiary Hospital ◽

P Value ◽

Fistula Repair ◽

Cross Sectional ◽

Genitourinary Fistula ◽

Successful Repair

Objective(s): To carry out a prospective review of patients who had undergone surgical repair of genitourinary fistula to determine patients characteristics and to explore success of surgery in relation to aetilogy of fistula and attempt of surgery.Materials and Methods : This cross-sectional study was carried out in patients attending the Fistula centre in Dhaka Medical College and Hospital (DMCH) from April 27th to July25th, 2013. Out of 47 patients 27 were recruited for this study. Detailed history was taken about socio-demographic character, gestational age, duration of labour, mode of delivery, conduction of labour and foetal outcome. Causes of fistula, information about fistula repair and success rate were noted. Main outcome measures were successful repair and correlation of success with aetiology of fistula, attempt of surgery. Data were analyzed by SPSS package. A p value of <0.5 was considered as significant.Results: Mean age of the patients was 33.73± 10.73 years with a range of 17 to 58 years and mean height was 144.67±3.013cm. Most of the women (66.7%) were from lower social class. The most common fistula 19 (70.37%) was obstetric due to obstructed labour and in 8 (25.93%) cases it was due to consequence of gynaecological surgery. Mean gestational age of the foetus were 38.57±1.409 weeks and duration of labour was 34.83±14.618 hours. Out of 27 patients, 7 had prior fistula repair without success, 4 patients had prior 2 attempts and 3 had previous 3 and 4 attempts. In 21 patients surgical repair was done through vaginal route while 6 required abdominal approach. Local repair was done in 18 (66.67%) cases and grafting was done in 5(18.52%) cases. Fifteen (55.56%) patients had successful repair and success rate was more when it was first attempted (90%) and 20% in repeat attempt but it was statistically significant p<0.05. Success of repair was more when causes of fistula was gynaecological (87.50%) than when it was obstetrical (42.11%), p<0.05.Conclusion: Success of surgery of genitourinary fistula depends upon so many factors. Gynaecological fistula can be repaired more successfully than obstetrical one. First attempt of surgery is the best attempt, so must be done at skilled hand.Bangladesh J Obstet Gynaecol, 2016; Vol. 31(1) : 34-39

Download Full-text