Urethral Diverticula, Urethro-Vaginal Fistulae, Vesico-Vaginal Fistulae

Obstetric-associated lower urinary tract injuries: A case series from a tertiary centre in a low-resource setting

Obstetric-associated lower urinary tract injuries may occur during vaginal and abdominal deliveries. If these injuries go unrecognised, these patients may suffer both physical and psychosocial complications. We describe the management of 19 patients with such injuries, including their demographic profile, associated factors, and complications at a tertiary institution in a retrospective case series over a 5-year period. Bladder injuries were the most common (89.5%), mostly occurring during emergency caesarean delivery, with previous caesarean delivery and adhesions being risk factors. A primary repair was attempted at the referring institution in 35.7% of cases. Repair at the tertiary institution was mostly performed by consultants (42.9%). Early recognition and primary repair are found to reduce further complications.

[Stage-by-stage treatment of vesicovaginal fistula followed by orthotopic plastic surgery of the bladder and vagina with a small intestine]

High incidence of iatrogenic lesions of genitourinary system (during gynecological and oncogynecological operations) followed by urogenital fistulae and great percentage of recurrences after reconstructive surgery justify the need to improve surgical reconstruction of genitourinary organs and urine discharge in these patients. Stage-by-stage surgical treatment of a patient with extensive vesicovaginal fistula is reported in the article. A defect was associated with loss of 2/3 of the volume of tissues of adjacent organs. Multiple operations in various clinics were failed to eliminate the fistula and resulted decrease of bladder capacity up to microcystis.

Transvaginal sonographic diagnosis of female urethral diverticula

PURPOSE

We report our experience with transvaginal sonography (TVUS) in the diagnosis of female urethral diverticulum (UD).

METHOD

We reviewed the TVUS examinations of 4 patients with a clinical diagnosis of UD and correlated the sonographic findings with the operative findings, especially regarding the UD's size, content, and location.

RESULTS

All UDs were demonstrated on TVUS. The size, content, and location of the UD correlated well with the operative findings.

CONCLUSION

TVUS is accurate in diagnosis and determination of the size, content, and location of female UD.