vesicovaginal fistulas
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2022 ◽  
Vol 29 (1) ◽  
Author(s):  
Muhammad Ilhamul Karim ◽  
Tjahjodjati

Objective: This study was conducted to find out the frequency and characteristics of urovaginal fistula patients. Material & Methods: This study design used a retrospective descriptive research design conducted at a tertiary hospital in West Java, Indonesia (Hasan Sadikin General Hospital) from 1 January 2010 to 31 December 2016. Results: Of all 22 urovaginal fistula patients, the majority in the age range of 41-50 years, and there was one patient in the age range of 61-70 years. Fourteen patients (63.6%) had defects in the bladder, and 36.5% of patients had defects in the ureters. There were nine patients (40.9%) who had urovaginal fistula after undergoing a hysterectomy procedure. The other causes were cervical carcinoma (40.9%), difficult labor (9.1%), radiotherapy (4.5%), carcinoma rectum (4.5%), cesarean section procedure (9.1%), and other gynecological procedures such as myomectomy or cystectomy (9.1%). Based on the type and location of the fistula, the majority of patients had vesicovaginal fistula/VVF (59%), ureterovaginal fistula/UVF (36%), and a combination of ureterovesicovaginal fistula (5%). The causes of VVF and UVF are different from each other. In patients with VVF, the most common cause is cervical carcinoma (35.7%). Meanwhile, the most common cause of UVF is hysterectomy (75%). Conclusion: Of the various types of urovaginal fistulas, vesicovaginal fistulas are the most frequently encountered. In general, the characteristics of urovaginal fistula patients in Hasan Sadikin General Hospital is slightly different from the literature, especially the cause of fistula. At Hasan Sadikin General Hospital, vesicovaginal fistulas are mostly caused by cervical cancer, not a hysterectomy. For ureterovaginal etiology, the characteristics of patients in Hasan Sadikin General Hospital are caused mainly by hysterectomy.


2021 ◽  
Vol 11 (4-S) ◽  
pp. 5-8
Author(s):  
Eighty Mardiyan Kurniawati ◽  
Nur Anisah Rahmawati

Background: Post-surgical wound healing in cases of vesicovaginal fistulae is a challenge because it is related to infection prevention and the long-term well-being of women. Aim: The aim of this research was to critically review the application of regenerative medicine in wound healing. The next aim was to look in depth to see whether regenerative medicine strategies have a place in the future of wound healing in a clinical setting. More specifically, to see if these strategies would apply for vesico vaginal fistulae case in the field of urogynecology. Method: A narrative literature review examines several previous research published at the last 5 years, containing keywords, namely vesicovaginal fistulae, regenerative medicine, wound healing. We used databases from Google Scholar, PubMed and Scopus Database. Results: A vesicovaginal fistula is an abnormal communication between the bladder and the vagina. There are currently no precise guidelines for the postoperative management of patients after fistula repair. Transvaginal surgical procedures are a common solution for vesicovaginal fistulas. In wound healing, more attention is needed because of the risk of infection especially wound healing in the area of ​​​​the reproductive organs. It should also be noted that stress urinary incontinence is a common complication. Several studies have initiated the trial process of regenerative medicine for using in urogynecological cases. Conclusion: In the management of vesico vaginal fistula cases, regenerative medicine can be a solution in postoperative care but still needs further development and standardization. Keywords: placenta, urogynecology, regenerative medicine


2021 ◽  
Vol 13 (2) ◽  
pp. 175-178
Author(s):  
M.A. Tavares ◽  
S. Campagne Lpiseau ◽  
M. Canis ◽  
R. Botchorishvili

Background: Vesicovaginal fistulas (VVF) are an unusual problem that may significantly affect a patient’s quality of life. The main causes for this condition are labour complications (mostly in developing countries) and pelvic surgeries (in industrialised countries). Treatment may be conservative or surgical. Regarding surgical treatment, there is still debate about the best approach and surgical technique. Objective: To demonstrate a correction of a VVF guided by cystoscopy using intravesical laparoscopic instruments. Methods: Case report and surgical video of a recurrent VVF treated with a hybrid technique involving direct transvesical insertion of 3 mm laparoscopic trocars and instruments guided by cystoscopy. As far as we know, although there are some reported techniques that use a combination of transvesical laparoscopic instruments and cystoscopy, this is the least invasive and most ergonomic technique described. Results: Two years after surgery, the patient remains asymptomatic and with no fistula recurrence. Conclusion: The transvesical approach guided by cystoscopy seems to be an effective, safe and ergonomic minimally invasive procedure for VVF repair.


2021 ◽  
Vol 79 ◽  
pp. S528
Author(s):  
F. Michel ◽  
H. Bensadoun ◽  
S. Gaillet ◽  
R. Boissier ◽  
V. Delaporte ◽  
...  

2021 ◽  
Vol 12 (2) ◽  
Author(s):  
Muhammed khalid ◽  
Muhammad Hammad Hassan ◽  
Muhammad Asif ◽  
Qadeer Ahmad Tariq

BACKGROUND & OBJECTIVE:  Vesicovaginal fistula is one of the common gynecological problems faced by ladies in developing countries on account of certain significant lacunas in the healthcare delivery system and lack of awareness. The purpose of this study is to highlight our experience of primary vesicovaginal fistula repair. METHODOLOGY: It is a cross-sectional experimental study from February 2019 to February 2020. Nineteen consecutive patients having vesicovaginal fistulas up to 3 cm in size, single in number were included in the study while those having fistulas more than 3 cm, involving urethra, bladder neck, and ureteric orifice were excluded. After a detailed history, physical examination, laboratory workup, and cystoscopic examination under anesthesia, the fistulas were repaired. All information was noted on the pre-planned questionnaire for this purpose. RESULTS: There are around 63% of patients having fistula infratrigonal and the rest percentage on the supratrigonal area of the urinary bladder. The risk factor found hysterectomy in 32% of patients, unsupervised home delivery in 16% of patients, C-Section in 12% of patients, delivery by an untrained person in 26% of patients, induced miscarriages in 5% of patients, and other risk factors found in 12% patients. The 68% of patients managed through transabdominal and the rest 32% patients operated through the transvaginal approach. The surgery, either transabdominal or transvaginal, was successfully done in 84% of patients and failed in the rest of 16% of patients. CONCLUSION: Fistulas due to obstetric trauma were mostly preventable. The success of surgical repair was due to health professionals' expertise, the suitable decision about approach, method of repair, proper preoperative evaluation, and careful postoperative management.


2021 ◽  
pp. 039156032110047
Author(s):  
Sunirmal Choudhury ◽  
Avisek Dutta ◽  
Naveen Gupta ◽  
Dilip Kumar Pal

Aim: In this study our idea is to compare the effectiveness of using interposing layer of fibrin glue to omental flap in reducing the failure of laparoscopic vesicovaginal fistula repair. Methods: Forty patients with fairly large vesicovaginal fistula were enrolled and divided in two groups of 20 each. We have used fibrin glue in one group and omental flap in the other group. Result: Of 20 patients in fibrin glue group no failure was seen, while 5 patients out of 20 in omental flap group had failure. Conclusion: This result is statistically significant and hence use of fibrin glue to be considered during laparoscopic repair of vesicovaginal fistulas.


GYNECOLOGY ◽  
2021 ◽  
Vol 23 (1) ◽  
pp. 97-101
Author(s):  
Denis P. Kholtobin ◽  
Aziz O. Nabiev ◽  
Sergey A. Nekludov ◽  
Ekaterina V. Kulchavenya

Urogenital fistulas are common complication of obstetric and gynecological surgery; the most common are vesicovaginal fistulas. Vesicouterine fistulas are rare, which explains the difficulties in diagnosis and treatment. The literature review and own clinical case presented in article. A 43-years-old female patient was consulted with complaint of urinary leakage from vagina, which appeared 1 month after the cesarean section and vesicouterine fistula has been diagnosed. Successful laparoscopic treatment of vesicouterine fistula was performed at the Avicenna Medical Center after 3 months. The urethral catheter was removed 7 days after surgery. At control examination after 1, 3 and 6 months, ultrasound examination of the pelvic organs confirmed the consistency of the scar on the uterus. Urination remained free and painless, the patient did not notice urine leakage. This clinical observation shows the possibility of treating a vesicouterine fistula with a laparoscopic approach with a good result and the possibility of early rehabilitation.


Urologiia ◽  
2021 ◽  
Vol 1_2021 ◽  
pp. 21-26
Author(s):  
V.L. Medvedev Medvedev ◽  
A.M. Opolskiy Opolskiy ◽  
N.A.Gorban Gorban ◽  
M.I. Kogan Kogan ◽  
◽  
...  

Nowa Medycyna ◽  
2021 ◽  
Vol 28 (1) ◽  
Author(s):  
Maria Ciesielska

Vesico-vaginal fistula (VVF) was a a catastrophic and common complication of childbirth among American women. In the mid 1800s Dr. J. Marion Sims reported the successful repair of vesicovaginal fistulas with a technique he developed by performing multiple operations on on a group of young, enslaved, African American women who had this condition between 1846 and 1849. Numerous modern authors have attacked Sims’s medical ethics, arguing that he manipulated the institution of slavery to perform ethically unacceptable human experiments on powerless, unconsenting women. It is impossible to understand Sims’s operations within the clinical context of the 1840s. To avoid the problems of “presentism”, in which beliefs, attitudes, and practices of the 21st century are anachronistically projected backward into the early 19th century we have to judge Sims within the context of his time. This is the only way to understand that Sims’ first fistula operations were legal, that they were carried out with express therapeutic intent for the purpose of repairing these women’s injuries, that they conformed to the ethical requirements of his time, and that they were performed with the patients’ knowledge, cooperation, assent, and assistance. Though the legacy of Dr. Sims is for some authors controversial he still seems to be considered as “the father of gyncology” who developed the first consistently successful surgical technique for the vesico-vaginal fistula.


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