Cases reported "Vaginal Fistula"

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21/91. Suprapubic-vaginocutaneous fistula 18 years after a bladder-neck suspension.

    BACKGROUND: Several complications are associated with healing after pelvic reconstructive surgery for stress urinary incontinence. These include infection, hemorrhage, erosion, and fistula formation. CASE: A 67-year-old woman presented with simultaneously draining vaginal and suprapubic sinuses. Examination revealed a vagino-abdominal fistula. Surgical excision found an abscess around synthetic material from a previous bladder-neck suspension. CONCLUSION: Unusual fistulation can occur remotely from anti-incontinence surgery, especially when graft materials are used. ( info)

22/91. Chronic wuchereriasis presenting as a vaginoperineal fistula: report of a case with aspiration cytologic diagnosis.

    BACKGROUND: filariasis is often an occult disease with myriad presentations. Cytology has an established role in diagnosing clinically unsuspected cases. CASE: A 20-year-old female presented with recurring perineal ulcers, vaginal discharge and inguinal lymphadenopathy. radiology revealed a vaginoperineal fistula. Fine needle aspiration (FNA) of the ulcer bed and smears prepared from the ulcer discharge showed an adult, gravid, female filarial worm and unsheathed larvae. Similar microfilariae were also seen in FNA smears from inguinal lymph nodes. The atypical clinical presentation and unusual parasite morphology posed initial difficulties in characterization of the microfilarial species. CONCLUSION: This case report highlights the morphologic clues to the dif ferential diagnosis offilarial species on cytologic specimens. Chronic wuchereriasis presenting as a vaginoperineal fistula has not been reported previously. ( info)

23/91. Laparoscopic repair of ureterovaginal fistula: successful outcome by laparoscopic ureteral reimplantation.

    We describe our technique of laparoscopic repair of ureterovaginal fistula in a 34-year-old woman who developed a vaginal leak of urine 15 days after laparoscopic hysterectomy. laparoscopy and extravesical ureteral reimplantation with a stent was carried out. cystoscopy and stent removal was done after 6 weeks. The patient was dry. To our knowledge, laparoscopy for the repair of ureterovaginal fistula has not been described. This distressing condition can be corrected laparoscopically with obvious benefit to the patient. ( info)

24/91. Laparoscopic approach to an endometriotic vault fistula causing posthysterectomy "menstruation".

    endometriosis is a commonly prevalent disease but can include rare complaints posing a challenge to surgical treatment. We describe an unreported cause of menstruation after hysterectomy, which was revealed as an endometriotic tubo-ovarian mass that fistulated into the vaginal vault. A 37-year-old woman experienced monthly vaginal bleeding after hysterectomy. At laparoscopy a tubo-ovarian endometriotic mass was revealed with a fistula into the vaginal vault. The mass was adherent to the left ureter and the sigmoid colon. Laparoscopic excision of the mass and fistula after ureterolysis and bowel dissection was performed. This case describes an unreported cause of posthysterectomy menstruation. The management outlines the optimal surgical management of laparoscopic techniques combined with vaginal access to achieve complete excision with minimal patient morbidity. ( info)

25/91. choriocarcinoma complicated by a vaginal fistula, sepsis and hemorrhagic shock. Case report.

    A case of poor prognostic choriocarcinoma developing sepsis is described. The patient was treated with vaginal drainage of pelvic abscess metastases, bilateral hypogastric artery ligation to prevent hemorrhage and single-agent chemotherapy. ( info)

26/91. Unusual presentation of an appendiceal malignancy.

    Primary malignant epithelial tumors of the appendix are uncommon. The most common presentation of appendiceal malignancy is right lower abdominal pain suggestive of acute appendicitis. Presentation caused by loco-regional spread with involvement of neighboring organs is rare. We present the case of a 48-year-old woman with an appendiceal malignancy who presented with symptoms and signs suggestive of complicated diverticular disease with an enterovaginal fistula. From a review of the literature, this is the first report of an appendiceal malignancy presenting in this manner. ( info)

27/91. Congenital urogenital anomalies that are associated with the persistence of Gartner's duct: a review.

    The embryogenesis and management of congenital urogenital anomalies that are associated with ureteric ectopia and the persistence of Gartner's duct are discussed. Ureteric ectopia with Gartner's duct cyst is caused by the failure of separation of the ureteric bud from the mesonephric duct, which leads to persistence of Gartner's duct, frequently with cystic dilation. Abnormal development of the ureter subsequently causes maldevelopment or absence of the ipsilateral kidney. The diagnosis and treatment of 2 adult women with congenital urethrovaginal fistula that was associated with unilateral single ectopic ureter, renal agenesis, and Gartner's duct anomaly are presented. Surgical repair of the urethrovaginal fistulae and removal of the Gartner's duct and cyst was performed transvaginally. ( info)

28/91. Experiences with a xenograft (acellular bovine collagen matrix) in gynecologic fistula repairs.

    Urogenital fistulas are significant, though uncommon, complications of gynecologic surgery, and fistula repair can be a challenging surgery for even the most experienced gynecologist. An interposition xenograft (acellular bovine collagen matrix), derived from bovine pericardium, has been used to accomplish successful repairs. We report on five urogenital fistula cases in which an interposition xenograft was used in achieving a successful repair. The use of an interposition xenograft is a successful option in urogenital fistula repair. ( info)

29/91. The use of corium porcine graft for a malignant enterovaginal fistula.

    Palliative treatment of an enterovaginal fistula secondary to adenocarcinoma of the rectum in a 65-year-old woman with intraperitoneal corium porcine graft is reported. The patient had previously had a total colectomy for ulcerative colitis followed by excision of the rectal stump, mucosal proctectomy and ileostomy. ( info)

30/91. Ureterovaginal fistula following laparoscopic assisted vaginal hysterectomy: case report.

    Ureterovaginal fistula following laparoscopic assisted vaginal hysterectomy is reported. The injury was missed in the immediate post-operative period. There was delay in urological consultation. The patient later developed a ureterovaginal fistula which was repaired successfully with a ureteroneocystostomy four months later after the patient was seen in several hospitals. This case is reported to highlight one of the serious complications of laparoscopic surgery that can go unnoticed. The causes of ureteral injuries in laparoscopic surgery, prevention and management protocols are discussed. ( info)
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