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Fiona Katherine McCurdie, Joanne Moffatt, Kevin Jones
Kitovu Hospital in Masaka, Uganda, is a leading obstetric fistula repair centre in the country with the highest rates of fistula in the world. In this retrospective case review, the regional incidence and causative factors were studied in patients with vesicovaginal fistula (VVF) who were admitted at Kitovu Hospital. Fistula history included severity (ICIQ score), causes and outcomes of VVF were measured. Women suffered with symptoms of VVF for an average of 4.97 years with an average ICIQ severity score of 7...
March 9, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Roger Sun, Ines Koubaa, Elaine Johanna Limkin, Isabelle Dumas, Enrica Bentivegna, Eduardo Castanon, Sébastien Gouy, Cynthia Baratiny, Fyo Monnot, Pierre Maroun, Samy Ammari, Elise Zareski, Corinne Balleyguier, Éric Deutsch, Philippe Morice, Christine Haie-Meder, Cyrus Chargari
Objective: We report outcomes of cervical cancer patients with bladder invasion (CCBI) at diagnosis, with focus on the incidence and predictive factors of vesicovaginal fistula (VVF). Results: Seventy-one patients were identified. Twenty-one (30%) had para-aortic nodal involvement. Eight had VVF at diagnosis. With a mean follow-up time of 34.2 months (range: 1.9 months-14.8 years), among 63 patients without VVF at diagnosis, 15 (24%) developed VVF. A VVF occurred in 19% of patients without local relapses (9/48) and 40% of patients with local relapse (6/15)...
February 6, 2018: Oncotarget
W Y Zhang, H Hu, X P Zhang, Y R Sun, H R Wang, K X Xu
OBJECTIVE: To compare the feasibility and prognosis of different surgical methods used for vesicovaginal fistulas and to explore the value of electrocoagulation treating small ones. METHODS: The medical data of 19 patients who had undertaken transvaginal VVF repairs in Peking University People's Hospital between October 2008 and November 2016 were retrospectively collected. The follow-ups were performed. The patients' age ranged from 31 to 55 years with the median age of 48 years and the history length ranged from 1 month to 24 months with the median length of 3 months...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Thomas J I P Raassen, Carrie J Ngongo, Marietta M Mahendeka
INTRODUCTION: Ureteric injuries are among the most serious complications of pelvic surgery. The incidence in low-resource settings is not well documented. METHODS: This retrospective review analyzes a cohort of 365 ureteric injuries with ureterovaginal fistulas in 353 women following obstetric and gynecologic operations in 11 countries in Africa and Asia, all low-resource settings. The patients with ureteric injury were stratified into three groups according to the initial surgery: (a) obstetric operations, (b) gynecologic operations, and (c) vesicovaginal fistula (VVF) repairs...
October 11, 2017: International Urogynecology Journal
Burak Tatar, Taylan Oksay, Fatma Selcen Cebe, Sedat Soyupek, Evrim Erdemoğlu
OBJECTIVE: In developed nations, surgery, especially gynecologic procedures, is the major cause of vesicovaginal fistulas (VVFs). We retrospectively evaluated our treatment modalities for VVF repair caused by a gynecologic surgery, and discussed the reasons of selecting certain surgical techniques and their outcomes. MATERIALS AND METHODS: We compared the surgical procedure preferences of surgeons and their results with patient and surgeon characteristics for the management of VVFs after an inciting gynecologic surgery in Süleyman Demirel University Hospital, Isparta over a 10-year period...
March 2017: Turkish Journal of Obstetrics and Gynecology
Deliu Victor Matei, Vanna Zanagnolo, Mihai Dorin Vartolomei, Nicolae Crisan, Matteo Ferro, Luca Bocciolone, Angelo Maggioni, Ioan Coman, Ottavio de Cobelli
OBJECTIVE: Our first objective was to report our experience on robot-assisted vesico-vaginal fistula (VVF) repair after radical surgery for gynecologic malignancies without omental flap interposition using a da Vinci robotic system. The second objective was to critically review the literature in order to analyze surgical solutions used to avoid repair failure. MATERIALS AND METHODS: Five patients with VVF diagnosed after previous open surgery for gynecologic malignancies referred to our tertiary institutions were selected...
2017: Urologia Internationalis
Rachel A Moses, E Ann Gormley
BACKGROUND: Vesico-vaginal fistulae (VVF) remain the most prevalent genitourinary fistula detrimentally impacting quality of life. PURPOSE OF THE REVIEW: The purpose of this review is to examine relevant literature on management of VVF. RECENT FINDINGS: Obstructed labor is the leading cause of VVF in the developing world with most repairs performed via the transvaginal approach. Conversely, the predominate etiology in industrialized nations is iatrogenic injury with an increasing trend towards abdominal repair via a minimally invasive (laparoscopic and robotic) approach...
August 2017: Current Urology Reports
Steven N Shephard, Sunday J Lengmang, Stephen A Anzaku, Oluwatobi V Mamven, Carolyn V Kirschner
OBJECTIVE: To compare outcomes following surgical repair of genital fistula among Nigerian women with or without HIV. METHODS: A retrospective review was conducted of all genital fistula repair surgeries performed at Evangel Vesicovaginal Fistula Center in Jos, Nigeria, between January 1, 2004, and April 30, 2014. Patient characteristics, HIV status, genital fistula characteristics, and postoperative outcomes were assessed for between-group variance. The odds ratio (OR) and 95% confidence intervals (CIs) were the primary measures used for determining the association between HIV status and surgical outcomes...
September 2017: International Journal of Gynaecology and Obstetrics
Nicole Varble, Gabriel Trylesinski, Jianping Xiang, Kenneth Snyder, Hui Meng
An intracranial aneurysm (IA) is a cerebrovascular pathology that can lead to death or disability if ruptured. Abnormal wall shear stress (WSS) has been associated with IA growth and rupture, but little is known about the underlying flow physics related to rupture-prone IAs. Previous studies, based on analysis of a few aneurysms or partial views of three-dimensional vortex structures, suggest that rupture is associated with complex vortical flow inside IAs. To further elucidate the relevance of vortical flow in aneurysm pathophysiology, we studied 204 patient IAs (56 ruptured and 148 unruptured)...
May 2017: Journal of the Royal Society, Interface
G Luke Machen, Leah R Chiles, John Joyce, Kristofer R Wagner
INTRODUCTION: Although infrequent, when encountered vesicovaginal fistulas (VVF) are a difficult condition for both patients and physicians alike. After the first robotic repair was described in 2005, this has been an increasingly common treatment modality. At our institution between 2009 and 2014, eleven of these patients were evaluated and treated with robotic repair. However, fibrin sealant was used in place of the traditional tissue flap. Included are six patients who had previously undergone operative repair...
April 2017: Canadian Journal of Urology
Jang Hee Han, Hong-Wook Kim, Koon Ho Rha, Jang Hwan Kim
Extraperitoneal transvesicoscopic vesicovaginal fistula (VVF) repair has received limited use because of its narrow working space, longer operation time, and technical difficulty. The present study describes the feasibility of robotic-assisted transvesicoscopic VVF repair in an animal model. Two Yorkshire swine underwent robotic-assisted laparoscopic (RAL) VVF repair. With the 4 trocars, an artificial VVF was made in the supratrigonal area and VVF repair was performed in 3 layers as in open VVF repair methods...
June 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Rodolfo Milani, Matteo Frigerio, Stefano Manodoro
No abstract text is available yet for this article.
August 2017: International Journal of Gynaecology and Obstetrics
M Alexandra Friedman, Jonathan S Shaw, Kelly McGary, Kyle Wohlrab
Vesicovaginal fistula (VVF) is commonly associated with obstetric trauma, but in developed nations it is typically iatrogenic. To date, there have been no published reports of VVF resulting from consensual sexual activity with sex toys. A 19-year-old gravida 0 presented with leakage of clear urine from the vagina following repetitive use of a sex toy with her female partner. The fistula was repaired in the operating room using a vaginal approach and a layered closure. This is the first case report of a VVF caused by consensual sex toy use between same-sex partners...
August 2017: Sexual Health
Erin Kelly, Maria Y Wu, J Barry MacMillan
BACKGROUND: Post-hysterectomy vesicovaginal fistula (VVF) is rare. In addition to conventional abdominal and vaginal approaches, robotic-assisted VVF repairs have recently been described. We present a case of an extravesical, robotic-assisted VVF repair, without placement of an interposition graft performed in a Canadian teaching center. CASE: A 51-year-old woman presented with urinary incontinence 5 days after laparoscopic hysterectomy. Computed tomography cystogram, cystoscopy, and methylene blue dye test, confirmed a VVF above the bladder trigone...
March 28, 2017: Journal of Robotic Surgery
Barbara Bodner-Adler, Engelbert Hanzal, Eleonore Pablik, Heinz Koelbl, Klaus Bodner
BACKGROUND: Vesicovaginal fistulas (VVF) are the most commonly acquired fistulas of the urinary tract, but we lack a standardized algorithm for their management. Surgery is the most commonly preferred approach to treat women with primary VVF following benign gynaecologic surgery. OBJECTIVE: To carry out a systematic review and meta-analysis on the effectiveness of operative techniques or conservative treatment for patients with postsurgical VVF. Our secondary objective was to define the surgical time and determine the types of study designs...
2017: PloS One
Chisato Takagi, Hideo Baba, Kazuo Yamafuji, Atsunori Asami, Kaoru Takeshima, Nobuhiko Okamoto, Hidena Takahashi, Kiyoshi Kubochi
Rectovaginal fistula (RVF) and vesicovaginal fistula (VVF) are infrequent but distressing complications after pelvic surgery. However, their adequate treatment is not well described. Here, we simultaneously encountered and successfully treated RVF and VVF after radical surgery for rectal cancer. A 70-year-old woman underwent low anterior resection (LAR) combined with resection of the uterus, the bilateral adnexa, and the upper side of the vagina, as well as diverted ileostomy for rectal cancer. A month after the surgery, she developed urinary incontinence and underwent medical treatment, but her symptoms did not improve...
January 2017: Case Reports in Gastroenterology
D M Kopp, A M Bengtson, J H Tang, E Chipungu, M Moyo, J Wilkinson
OBJECTIVE: Determine whether a 1-hour pad test at discharge can identify continence status within 120 days of obstetric vesicovaginal fistula (VVF) repair. DESIGN: Prospective cohort study. SETTING: Fistula Care Centre in Lilongwe, Malawi. POPULATION: Women with VVF who underwent repair between January 2012 and December 2014. METHODS: Data on demographics, obstetric history, physical exam findings, operative management, postoperative findings, and follow up evaluations were collected on women with VVF repair...
May 2017: BJOG: An International Journal of Obstetrics and Gynaecology
Gaurav Vinod Kasat, Prakash W Pawar, Ajit S Sawant, Ashwin S Tamhankar
We present a rare case of indirect vesicovaginal fistula (VVF) in a patient with small capacity bladder. The fistula was between abdominal pseudocyst (APC) arising from bladder and vagina - and hence, an indirect VVF. A 35-year-old female had a history of emergency obstetric hysterectomy with iatrogenic bladder injury. Postoperatively, the patient developed VVF and large APC. Patient's micturating cystourethrogram was suggestive of small capacity bladder with bilateral Grade IV vesicoureteral reflux with a well-defined APC arising from superior surface of bladder to L4-L5 lumbar vertebrae...
October 2016: Urology Annals
Kara L Watts, Richard Ho, Reza Ghavamian, Nitya Abraham
INTRODUCTION AND HYPOTHESIS: High vesicovaginal fistulas (VVF) in the setting of good apical support are best repaired via a transabdominal approach. Laparoscopic VVF repair was first reported in 1998. Several series of robot-assisted VVF repairs have since been published. The robot-assisted approach allows repair of high apical vaginal fistulas while avoiding the morbidity of laparotomy, shortening convalescence, and facilitating the use of omental interposition flaps. This video presents the technique for robot-assisted extravesical VVF repair utilizing a laparoscopically mobilized omental flap...
April 2017: International Urogynecology Journal
Bastab Ghosh, Varun Wats, Dilip Kumar Pal
OBJECTIVE: Vesicovaginal fistula (VVF) causes detrimental psychosomatic effects on a woman. It is repaired using open abdominal as well as laparoscopic approach. Here we compare a series of open versus laparoscopic VVF repairs done at a single centre. METHODS: Retrospectively data of patients undergoing VVF repair in our department between January 2011 to December 2014 was analyzed. Patients who had a single, primary, simple VVF following a gynaecological surgery were included in the study...
November 2016: Obstetrics & Gynecology Science
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