VSD Surgery
Emergency Cases
What causes Vesicovaginal Fistula ?
The foremost cause of Vesicovaginal Fistula is difficult and unattended deliveries. Another cause of Vesicovaginal Fistula is injury during gynecologic surgery like hysterectomy where there is extensive dissection between the bladder and the uterus, unrecognized bladder laceration, inappropriate stitch placement, and/or devascularization injury to the tissues. Some factors that increase your risk of developing Vesicovaginal Fistula are the history of Pelvic Inflammatory Diseases, pelvic malignancy, endometriosis, infection, diabetes, prior pelvic or vaginal surgery and anatomic distortion of the vaginal vault.
What are the types of Vesicovaginal Fistula ?
Depending on the location, cause, complexity, or site of obstruction, Vesicovaginal Fistula can be classified as : –
- Simple Vesicovaginal Fistula: – In this type of Vesicovaginal Fistula, the length of the vagina is normal, the fistula is less than 2 cm long and there is no history of radiation or vagina/cervical malignancy. A simple Vesicovaginal Fistula is quite straightforward to repair.
- Complex Vesicovaginal Fistula: – In this type, vaginal length is shortened, there is history of pelvic malignancy which may have resulted in radiation therapy and is the fistula is more than 3 cm long. The repair of Complex Vesicovaginal Fistula is quite complicated and can pose a challenge to the surgeon.
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How is Vesicovaginal Fistula treated ?
The goal of surgical repair of the Vesicovaginal Fistula include adequate exposure, good homeostasis, wide mobilization of the bladder and vagina, resection of devascularized tissue and removal of foreign body, tension free closure, non-opposition of suture lines, and confirmation of a water tight seal on bladder closure, and postoperative bladder drainage for 10-14 days with the help of a foley’s catheter. Vesicovaginal Fistula can either be treated by vaginal approach or abdominal approach.
- Vaginal approach for the surgical repair of Vesicovaginal Fistula: – In the transvaginal approach for surgical repair of Vesicovaginal Fistula, the tissues of the vaginal wall is dissected and the fistula tract in the bladder mucosa is stitched with absorbable sutures to close. The excessive vaginal tissues are excised and the vaginal mucosa is then closed, completing the repair. The vaginal approach for the surgical repair is employed for simple and small Vesicovaginal Fistula.
- Abdominal approach for the surgical repair of Vesicovaginal Fistula: – In the transabdominal approach, an infra umbilical incision is made which is carried down into the peritoneal cavity. This method is used for the surgical repair of complex Vesicovaginal Fistula that may be large or small but multiple. The abdominal approach may be facilitated by Cystoscopically guided placement of a catheter through the fistulous tract. The bladder will be exposed, ureteral stents should be placed if the fistula is near the ureteral orifice. The vagina and bladder will then be closed with interrupted delayed absorbable sutures in a double-layer fashion.
How do I prepare for the surgical repair of Vesicovaginal Fistula ?
Ask your doctor about any special instructions to prepare for the surgical repair of the Vesicovaginal Fistula. Since all medical procedures have a small risk of injury, e.g. injury to the ureter or rectum, you will need to sign a consent form before the test. Do not hesitate to ask your doctor about any concerns you might have.
You may be asked to give a urine sample before the test to check for infection. Avoid urinating for an hour before this part of the test. Inform your physician about your other health conditions and medications (including all the prescription, and non-prescription medications, nutritional supplements i.e. vitamins, minerals and herbal products). Refrain from taking aspirin or Ibuprofen at least 2 weeks before the surgical repair of Vesicovaginal Fistula. Stop smoking a few weeks before the operation to prevent healing problems during the recovery period. Do not eat or drink anything for at least 10 hours before the Vesicovaginal Fistula surgery.
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will wear a hospital gown for the examination, and the lower part of your body will be covered with a sterile drape. In most cases, you will lie on your back with your knees raised and apart. The procedure will be performed under general anesthesia and you will be hospitalized for 3 – 4 days (for transabdominal approach) or 1 – 2 days (for transvaginal approach) for the surgical repair of Vesicovaginal Fistula. A nurse or technician will clean the area around your urethral opening and apply a local anesthetic.
What to expect during the recovery period following surgical repair of Vesicovaginal Fistula?
Ask your doctor about any special instructions to prepare for the surgical repair of the Vesicovaginal Fistula. Since all medical procedures have a small risk of injury, e.g. injury to the ureter or rectum, you will need to sign a consent form before the test. Do not hesitate to ask your doctor about any concerns you might have.
You may be asked to give a urine sample before the test to check for infection. Avoid urinating for an hour before this part of the test. Inform your physician about your other health conditions and medications (including all the prescription, and non-prescription medications, nutritional supplements i.e. vitamins, minerals and herbal products). Refrain from taking aspirin or Ibuprofen at least 2 weeks before the surgical repair of Vesicovaginal Fistula. Stop smoking a few weeks before the operation to prevent healing problems during the recovery period. Do not eat or drink anything for at least 10 hours before the Vesicovaginal Fistula surgery.
Looking for a free cost estimate for Cosmetic Surgery in India abroad –
Or email at info@wecareindia.com / Call +91 9029304141
will wear a hospital gown for the examination, and the lower part of your body will be covered with a sterile drape. In most cases, you will lie on your back with your knees raised and apart. The procedure will be performed under general anesthesia and you will be hospitalized for 3 – 4 days (for transabdominal approach) or 1 – 2 days (for transvaginal approach) for the surgical repair of Vesicovaginal Fistula. A nurse or technician will clean the area around your urethral opening and apply a local anesthetic.
Benefits of surgical repair of Vesicovaginal Fistula Surgery in india
In addition to the medical benefit from the repair of Vesicovaginal Fistula, you will also experience a profound effect on the your emotional well-being. The offensiveness from incontinence of urine can result in social alienation, ostrasization and immense emotional trauma. Surgical repair of Vesicovaginal Fistula can help you once again become part of the mainstream population.
Risks of surgical repair of Vesicovaginal Fistula : –
- Transient Vesicoureteral reflux and bladder spasm
- Recurrence of fistula.
- Ureteral stricture
- Infection
- Excessive bleeding
- Injury to other organs
- Thrombo-embolism
Do you have your medical reports; send us now for a free quote
Or email at info@wecareindia.com / Call +91 9029304141
Benefits of surgical repair of Vesicovaginal Fistula Surgery in india
In addition to the medical benefit from the repair of Vesicovaginal Fistula, you will also experience a profound effect on the your emotional well-being. The offensiveness from incontinence of urine can result in social alienation, ostrasization and immense emotional trauma. Surgical repair of Vesicovaginal Fistula can help you once again become part of the mainstream population.
Risks of surgical repair of Vesicovaginal Fistula : –
- Transient Vesicoureteral reflux and bladder spasm
- Recurrence of fistula.
- Ureteral stricture
- Infection
- Excessive bleeding
- Injury to other organs
- Thrombo-embolism
Do you have your medical reports; send us now for a free quote
Or email at info@wecareindia.com / Call +91 9029304141
Alternatives to surgical repair of Vesicovaginal Fistula : -
- Medical Treatment : –
- Hormone Replacement Therapy / Estrogen Replacement Therapy – This treatment assists with optimizing tissue vascularization and healing.
- Surgical Treatments: –
- Electrocautery – This method uses cauterization or burning to repair the Vesicovaginal Fistula Fibrin glue – Occlusion therapy using a combination of fibrinogen and thrombin are used as a sealant for the repair of Vesicovaginal Fistula
- Electrocautery and endoscopic closure using fibrin glue and bovine collagen – After performing Electrocautery of the fistula, a Cystoscope will be inserted into the bladder through your urethra, and 1 mm of bovine collagen will be injected submucosally under direct visualization around the fistula opening. Fibrin glue will be injected transvaginally into the fistula tract. A second application of 1 mm of bovine collagen will then be injected transvaginally into the vaginal mucosal layer around the fistula tract.
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