Cases reported "Urinary Incontinence"

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1/38. The Mitrofanoff urinary diversion for complex vesicovaginal fistulae: experience from uganda.

    OBJECTIVE: To evaluate the results of Mitrofanoff continent urinary diversion in a group of women with persistent severe incontinence after vesicovaginal fistula (VVF) secondary to obstructed labour. patients AND methods: Seven women with severe incontinence following a VVF were offered the Mitrofanoff procedure after all other attempts had failed to restore continence. In three patients a caecocystoplasty formed the urinary reservoir and in four the bladder was used. In all seven patients the appendix was used as the conduit for self-catheterization. The mean (range) follow-up was 10 (3-14) months. RESULTS: One patient died postoperatively from hepatic failure, which could not be attributed to the particular procedure. One patient required re-operation at 10 days to adjust the conduit, but of the six patients who recovered, all are fully continent and self-catheterizing with no difficulty. CONCLUSION: The Mitrofanoff procedure appears to be a valuable technique to restore continence in this difficult group of patients.
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ranking = 1
keywords = fistula
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2/38. Congenital vesicovaginal fistula.

    Congenital vesicovaginal fistula is a very rare entity, the etiology of which has not been clearly elucidated because pathologic features have not been mentioned in previous reports. The case of a 4-year-old girl having incontinence resulting from a congenital vesicovaginal fistula joining with the left ectopic ureter from the hypoplastic kidney is described. This is thought to be the first presentation of congenital vesicovaginal fistula joining with ectopic ureter. A microscopic examination revealed the fistula consisting of transitional cell epithelium, suggesting an abnormal fusion of the ureteral bud and caudal end of the mullerian duct with the urogenital sinus.
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ranking = 1.6
keywords = fistula
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3/38. Vesicocervical fistula: an unusual presentation.

    A rare case is presented of vesicocervical fistula that occurred in a woman who sought help for continuous dribbling of urine for nine years. The aetiological implications of her obstetric history are discussed in the context of previous reports in the literature. The management and outcome of this case is discussed.
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ranking = 1
keywords = fistula
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4/38. Postirradiation vesicovaginal fistula completely resolved with conservative treatment.

    Postirradiation vesicovaginal fistulae (VVF) pose a great challenge for the urologist. The poorly vascularized radiated tissue surrounding the fistula impairs healing and makes operative repair technically demanding. Conservative treatment for postirradiation VVF is considered inappropriate, and to our knowledge has never previously been described. We present a case of a woman with postirradiation VVF that was resolved after transurethral coagulation and 3 weeks of catheterization.
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ranking = 1.2
keywords = fistula
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5/38. Youssef's syndrome.

    A case of menouria (Youssef's syndrome) following a vesicovaginal fistula repair is presented. The patient had typical clinical features of cyclic hematuria, absence of vaginal bleeding and complete urinary continence. diagnosis was established by cystoscopy, cystography and hysterosalpingography which disclosed the communication between the bladder and the uterine cavity. Surgical treatment was hysterectomy with the closure of the bladder opening. The authors quote similar cases reported in the literature and attention is also called to the fact that the first case of menouria was reported in the literature by Machado in 1935.
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ranking = 0.2
keywords = fistula
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6/38. Novel technique for combined repair of postirradiation vesicovaginal fistula and augmentation ileocystoplasty.

    Concomitant vesicovaginal fistula and significant bladder contracture after radiation is an uncommon but complex urologic problem. We describe a surgical technique to address both issues and present our preliminary clinical data.
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ranking = 1
keywords = fistula
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7/38. An unusual case of a vesicovaginal stone.

    We report a case of an unusual vesicovaginal stone. The dumb-bell-shaped stone created a ball valve effect in the fistula, therefore giving rise to only mild urinary leakage despite the large size of the fistula.
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ranking = 0.4
keywords = fistula
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8/38. Urologic and plastic surgical collaboration for continent diversion when urine leakage is complicated by pressure ulcers or obesity.

    BACKGROUND: patients with neurogenic bladder dysfunction and urine leakage combined with pressure ulceration, fistulae, and/or obesity present a major surgical challenge. Given the urgent need to control urine leakage, suprapubic cystostomy or incontinent urinary diversion such as ileal conduit often are chosen for definitive intervention, despite the fact that continent urinary diversion generally is the preferred method of management for the motivated patient. DESIGN: Case series. METHOD: This article presents 4 patients in whom urine leakage was complicated by pressure ulcers, urethral erosion, and/or morbid obesity. Due to the complicated nature of their problems, these patients were managed in a collaborative fashion by the departments of urology, plastic surgery, and physiatry. Each of these patients underwent a combined surgical intervention that addressed issues of skin ulceration or morbid obesity and allowed for continent urinary diversion. RESULTS: After intervention, all 4 patients were independent in bladder management and were completely continent. CONCLUSION: This series demonstrates how collaboration between the urologist and plastic surgeon in evaluation and treatment planning allows for the formulation of surgical options that include continent urinary diversion.
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ranking = 0.2
keywords = fistula
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9/38. Congenital vesicovaginal fistula in association with hypoplastic kidney and uterus didelphys.

    Abnormalities of the lower urinary and genital tracts commonly coexist, although congenital vesicovaginal fistula is extremely rare. We report the first case of congenital vesicovaginal fistula and hypoplastic kidney in association with uterine didelphys. Despite extensive investigation throughout childhood, a definitive diagnosis was not made until 16 years of age. We discuss some of the difficulties that might arise in diagnosing a small vesicovaginal fistula in the presence of a fusion abnormality of the genital tract and suggest how such cases might be investigated and managed surgically.
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ranking = 1.4
keywords = fistula
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10/38. Can epithelized neobladder-cutaneous fistula provide urinary continence?

    The paper presents a case of a boy born with a bladder exstrophy, who underwent several surgical procedures, including bladder augmentation. During the last procedure, the patient received a suprapubic catheter that accidentally slipped out. The epithelized neobladder-cutaneous fistula resulted in a continent and easily catheterizable abdominal stoma.
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ranking = 1
keywords = fistula
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