Tag: urology

– Repair of vesicovaginal fistula is a surgical procedure to close or remove a fistula between the bladder and vagina.
– Before surgery, patients may be instructed to fast and shower with a specific soap to prevent infection.
– General anesthesia is administered during the surgery.
– Stents may be inserted in the ureters to protect them during surgery.
– The fistula is either excised or closed with stitches, and the incision is closed with stitches.
– Antibiotic-soaked bandages may be placed in the vagina to prevent infection.
– In some cases, an incision may be made through the abdomen, and a suprapubic catheter may be inserted into the bladder for urine drainage.
– Risks of the surgery include excessive bleeding, infection, damage to the ureters, bladder spasms, vaginal bleeding, bladder stones, incomplete bladder emptying, smaller bladder, shortened vaginal canal, and the possibility of a new fistula forming after surgery.
– Repair success is achieved by performing the repair in a single layer, using a non-absorbable suture material.
– Some surgeons use absorbable sutures for the vaginal closure to avoid suture-induced granulomas.
– Repair of vesicovaginal fistula in radiation patients may require additional techniques like omentoplasty or myocutaneous flap interposition.
– Different surgical techniques for VVF repair include vaginal and abdominal approaches.
– The success rates for VVF repair are high if certain surgical principles are followed.
– Vascularized flaps or grafts may be used for repairing large or radiotherapy-related fistulas.
– Different incisions such as the Dührssen and Schuchardt incisions can be used to improve exposure during surgery.