Cases reported "Vaginal Fistula"

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1/6. ureteroscopy: a new asset in the management of postoperative ureterovaginal fistulas.

    Iatrogenic ureteral injury, an uncommon entity, is primarily caused by complications of gynecologic surgery. This report describes a case of ureterovaginal fistula discovered 13 days after a vaginal hysterectomy. ureteroscopy was performed, with passage of an indwelling ureteral stent for 6 weeks. The patient immediately became continent of urine and the fistula healed, thus avoiding the need for further surgery.
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ranking = 1
keywords = gynecologic
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2/6. Treatment of small intestinal fistulas with octreotide, a somatostatin analog.

    Three patients with external small bowel fistulas were successfully treated with bowel rest, total parenteral nutrition, and the somatostatin analog, octreotide. Two of the patients had received prior multimodality therapy, including radiation, for gynecologic cancer. The time intervals to fistula closure were 2 days, 10 days, and 5 weeks after initiation of octreotide therapy. The efficacy of octreotide combined with total parenteral nutrition in the treatment of external enteric fistulas supports its routine use, especially in previously irradiated patients.
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ranking = 1
keywords = gynecologic
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3/6. 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.
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ranking = 5
keywords = gynecologic
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4/6. Clinical presentation and management of cervicovaginal fistula.

    Cervico-Vaginal fistula involving the internal cervical os may lead to obstetric as well as gynecologic problems. This report documents cervicovaginal fistula causing repeated early pregnancy losses in 2 cases, Cu-T IUCD failure in one and chronic leukorrhea misleading the diagnosis of cervical polyp in another.
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ranking = 1
keywords = gynecologic
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5/6. Full-thickness Martius grafts to preserve vaginal depth as an adjunct in the repair of large obstetric fistulas.

    We performed a modified bulbocavernosus full-thickness pedicle graft procedure on four patients with large obstetric fistulas in ghana, West africa. The bulbocavernosus fat pad was harvested in the usual manner, and the full-thickness skin patch was taken from the medial thigh. All grafts showed 100% take by the tenth postoperative day. Adequate vaginal depth and caliber were obtained in all patients. Sexual function resumed in all patients except one, who suffered a recurrent vesicovaginal fistula. This method of vaginoplasty may be useful in patients who have massive vaginal-wall destruction of either gynecologic or obstetric origin.
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ranking = 1
keywords = gynecologic
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6/6. Use of endoscopy in the management of postoperative ureterovaginal fistula.

    The aim of the study was to evaluate endourological techniques in the management of iatrogenic ureterovaginal fistula. Seventeen patients referred to us after gynecologic surgery were diagnosed as having iatrogenic ureterovaginal fistula. First, retrograde double-J stenting was tried. If this failed, percutaneous nephrostomy using an antegrade double-J stent was performed. If this also failed, open surgical repair was performed. The retrograde double-J stent bypassed the fistula in 2 patients (11.8%). Percutaneous nephrostomy was performed in the remaining 15. The antegrade double-J stent bypassed the fistula in another 2 of these patients (11.8%). Open surgical repair was performed in the remaining 13 patients (67.5%) (direct ureteroneocystostomy) with nipple valve in 11 patients and Boari flap with psoas hitch in 2 patients). Of all patients, 2 had ureteral stricture, one after antegrade double-J stenting and the other after open repair. It was concluded that early intervention is recommended in the treatment of iatrogenic uretrovaginal fistula, causing minimal morbidity and discomfort, and being less expensive.
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ranking = 1
keywords = gynecologic
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