Urethrovaginal Fistula

2004 ◽  
pp. 797-810
Author(s):  
John Gebhart ◽  
Raymond Lee
Keyword(s):  
Urethrovaginal Fistula

Urogenital Fistulas and Female Urethral Diverticula

2020 ◽  
Author(s):  
Lindsey Cox ◽  
Eric S. Rovner
Keyword(s):  
Urinary Tract ◽  
Surgical Techniques ◽  
Signs And Symptoms ◽  
Urethral Diverticulum ◽  
Vascular Supply ◽  
Organ System ◽  
Fistula Tract ◽  
Urethrovaginal Fistula ◽  
Urogenital Fistula ◽  
Tract Fistula

Urogenital fistulas are a group of conditions in which the urinary tract is apparently connected to another organ system. Causes of fistula range from congenital anomalies, malignancy, trauma, infection or inflammatory conditions, ischemia, parturition, and iatrogenic sources – including surgery and radiation. Signs and symptoms of urinary tract fistula are variable and depend on the organ system involved and the size of the fistula. For patients who are appropriate surgical candidates, elective surgical repair is the mainstay of treatment of urinary tract fistula. Surgical techniques can be complex, but rely on the same key concepts: adequate exposure of the fistula tract; careful dissection and separation of the tissue layers, while minimizing cautery; multi-layer closure; watertight closure of each layer; meticulous hemostasis to prevent hematoma formation, but preserve vascular supply of tissues; use of well-vascularized tissue flaps; tension-free, non-overlapping suture lines; biopsy of tissues concerning for malignancy. This review contains 6 figures, 5 tables, and 82 references. Keywords: urogenital fistula, female bladder, vesical fistula, urinary bladder fistula, vesicovaginal fistula, urethrovaginal fistula, vaginal fistula, urethral diverticulum, urethral diverticulectomy, female urethra

scholarly journals Management of Urethral Lesions and Urethrovaginal Fistula Formation Following Placement of a Tension-Free Suburethral Sling: Evaluation From a University Continence and Pelvic Floor Centre

2018 ◽  
Vol 78 (10) ◽  
pp. 991-998 ◽  
Author(s):  
Dorit Schöller ◽  
Sara Brucker ◽  
Christl Reisenauer
Keyword(s):  
Urinary Incontinence ◽  
Skin Flap ◽  
Vaginal Surgery ◽  
Mixed Urinary Incontinence ◽  
Fistula Formation ◽  
Anticholinergic Medication ◽  
Two Phase ◽  
Urethrovaginal Fistula ◽  
Tension Free ◽  
Tape Position

Abstract Introduction The complication of tape erosion in the urethra following placement of a retropubic (TVT) or transobturator (TOT) tension-free suburethral vaginal sling or an accidental iatrogenic transurethral tape position can result in the formation of a urethrovaginal or vesicovaginal fistula. The objective of the investigation is the evaluation of the management of such rare complications. Patients and Methods Retrospective analysis of 14 patients who were treated for a urethral lesion or urethrovaginal fistula formation status post TVT/TOT placement between June 2011 and February 2018 in the Tübingen University Department of Gynaecology. Results As surgical therapy, 57.1% (n = 8) cases underwent vaginal fistula closure using a Martius flap of the labium majus and in 21.4% (n = 3) using a vaginal rotation skin flap. In 21.4% (n = 3), exclusively vaginal suture reconstruction of the urethra following excision of the tape running transurethrally or tape erosion was performed. 50% (n = 7) of the patients had lasting continence postoperatively without any further need for therapy. In 28.6% (n = 4), there was ongoing stress urinary incontinence, in 21.4% (n = 3) mixed urinary incontinence. Six of the 7 patients with persistent incontinence underwent new placement of a tension-free suburethral retropubic sling (TVT) an average of 8.8 months (5 – 13 months) postoperatively which was uncomplicated in all patients and achieved satisfactory continence. The 3 patients with mixed urinary incontinence and persistent urgency components additionally received anticholinergic medication. During the time period investigated, there were no long-term complications, in particular no recurrent fistulas. Conclusion The rare but relevant complications of a urethral erosion, transurethral tape position or urethrovaginal fistula formation status post TVT/TOT placement can be successfully managed via vaginal surgery. Persistent postoperative urinary incontinence with the need for a two-phase repeat TVT placement following sufficient wound healing must be preoperatively clarified.

scholarly journals Closure of a Recurrent Urethrovaginal Fistula in a Girl with Cloacal Anomaly Using Deflux Injection

2018 ◽  
Vol 06 (01) ◽  
pp. e52-e55 ◽  
Author(s):  
Hanan Said ◽  
Salahuddin Syed ◽  
Ali Zeinelabdeen ◽  
Mohamed Fayez
Keyword(s):  
Treatment Option ◽  
Bladder Neck ◽  
Open Surgery ◽  
Vesicovaginal Fistula ◽  
Urethrovaginal Fistula ◽  
Ureteric Reimplantation ◽  
Cloacal Anomaly ◽  
Diverting Colostomy

AbstractIn a girl born with cloaca, both hemivaginae and rectum were located above the bladder neck, and both ureters were connected to the hemivaginae. After diverting colostomy and cystovaginoscopy on the second day of life, the repair of cloaca was performed at 10 months of age by posterior sagittal anorecto vaginoplasty (PSARVP), including laparotomy and bilateral ureteric reimplantation. Eight months after the surgery, she developed a vesicovaginal fistula, which was repaired and closed by open surgery through the bladder. Three months after this procedure, a tiny urethrovaginal fistula was noticed, which was closed at the age of 2 years using hook diathermy to refresh the edges and was then closed by Deflux injection. The proper closure of the urethrovaginal fistula was confirmed by radiology and cystoscopy 3 months after the surgery. This report shows that injection of Deflux into a tiny urethrovaginal fistula following refreshing the edges may be a valid treatment option in selected cases.

Urethrovaginal fistula repair

2009 ◽  
Vol 10 (5) ◽  
pp. 321-325
Author(s):  
Daniel Caruso ◽  
Angelo E. Gousse
Keyword(s):  
Fistula Repair ◽  
Urethrovaginal Fistula

URETHROVAGINAL FISTULA

2008 ◽  
pp. 775-781
Author(s):  
Jason P. Gilleran ◽  
Philippe E. Zimmern
Keyword(s):  
Urethrovaginal Fistula

Female Urethrovaginal Fistula

2009 ◽  
pp. 853-858
Author(s):  
Frank Hinman ◽  
Laurence S. Baskin
Keyword(s):  
Urethrovaginal Fistula

scholarly journals Urethrovaginal fistula repair with or without concurrent fascial sling placement: A retrospective review

2020 ◽  
Vol 15 (5) ◽  
Author(s):  
Sarah Neu ◽  
Jennifer Locke ◽  
Mitchell Goldenberg ◽  
Sender Herschorn
Keyword(s):  
Patient Characteristics ◽  
Urethral Diverticulum ◽  
Pelvic Surgery ◽  
Study Patient ◽  
Complication Rates ◽  
Urethrovaginal Fistula ◽  
Fascial Sling ◽  
Significant Difference ◽  
Sling Placement

Introduction: We sought to review outcomes of urethrovaginal fistula (UVF) repair, with or without concurrent fascial sling placement. Methods: All patients diagnosed with UVF at our center from 1988–2017 were included in this study. Patient charts were reviewed from a prospectively kept fistula database, and patient characteristics and surgical outcomes were described. Descriptive statistics were applied to compare complication rates between patients with or without fascial sling placement at the time of UVF repair. Results: A total of 41 cases of UVF were identified, all of which underwent surgical repair. Median age at diagnosis was 49 years (interquartile range [IQR] 35–62). All patients had undergone pelvic surgery. UVF etiology was secondary to stress urinary incontinence (SUI) surgery in 17 patients (41%) and urethral diverticulum repair in seven patients (17%). The most common presenting symptom was continuous incontinence in 19 patients (46%). Nineteen patients had a fascial sling placed at the time of surgery (46%), with no significant difference in complication rates (26% vs. 23%, p=0.79). Two patients had Clavien-Dindo grade I complications (5%) and one had a grade III complication (2%). Four patients had long-term complications (10%), including urinary retention, chronic pain, and urethral stricture. Two patients had UVF recurrence (5%). Median followup after surgery was 21 months (IQR 4–72). Conclusions: UVF should be suspected in patients with continuous incontinence following a surgical procedure. Most UVF surgical repairs are successful and can be done with concurrent placement of a fascial sling.

Urethrovaginal Fistula: A Review of the Surgical Management

1984 ◽  
Vol 132 (3) ◽  
pp. 460-462 ◽  
Author(s):  
George D. Webster ◽  
Stephen A. Sihelnik ◽  
Anthony R. Stone
Keyword(s):  
Surgical Management ◽  
Urethrovaginal Fistula
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