Hellow guys, Welcome to my website, and you are watching LARGE COMPLEX VESICOVAGINAL FISTULA REPAIR (TRIGONAL WITH SUPRATRIGONAL). and this vIdeo is uploaded by Dr Mayank Mohan Agarwal at 2023-08-16T10:20:05-07:00. We are pramote this video only for entertainment and educational perpose only. So, I hop you like our website.
| Name | LARGE COMPLEX VESICOVAGINAL FISTULA REPAIR (TRIGONAL WITH SUPRATRIGONAL) |
| Video Uploader | Video From Dr Mayank Mohan Agarwal |
| Upload Date | This Video Uploaded At 16-08-2023 17:20:05 |
| Video Discription | 32 YEAR OLD WOMAN PRESENTED WITH PERSISTENT LEAK OF URINE THROUGH VAGINA FOR 6 MONTHS. SHE HAD UNDERGONE EMERGENCY CAESAREAN SECTION AFTER PROLONGED LABOR AT ANOTHER HEALTH CENTER. AT PRESENTATION, SHE HAD LARGE VESICOVAGINAL FISTULA FROM BLADDER NECK TO SUPRATRIGONAL (~4CM IN DIA) REACHING WITHIN 1CM OF BILATERAL URETERIC ORIFICES AND UPTO ANTERIOR FORNIX INVOLVING ANTERIOR SURFACE OF CERVIX. AFTER EVALUATION SHE UNDERWENT BILATERAL URETERIC CATHETERIZATION AND LAPAROSCOPIC VESICOVAGINAL FISTULA REPAIR WITH OMENTAL INTERPOSITION IN KEEPING WITH O’CONNOR SURGICAL PRINCIPLES. DENSE ADHESIONS WITH FIBROSIS WERE FOUND SURROUNDING THE FISTULA MANDATING EMPLOYMENT OF CLASSICAL O'CONNOR REPAIR BIVALVING THE BLADDER (ALTHOUGH BIVALVING WAS SUBTOTAL IN OUR CASE). CAREFUL DISSECTION ALONG WITH EDGES OF FISTULA SAFEGUARDING URETERIC ORIFICES AND MAINTAINING INTEGRITY OF BLADDER NECK HELPED FINISH THE PROCEDURE BY PRIMARY CLOSURE. URETERIC REIMPLANTATION AND BLADDER NECK RECONSTRUCTION WERE NOT REQUIRED. IN OUR OPINION INTERPOSITION OF OMENTAL FLAP PROVIDES ADDITIONAL VASCULARIZED TISSUE HELPING HEALING (ALTHOUGH NO RCT IS AVAILABLE IN THIS REGARD). PATIENT'S BLADDER'S FILLING AND VOIDING FUNCTIONS WERE PRESERVED. IT INDIRECTLY POINTS TOWARDS ETIOLOGY OF FISTULA BEING TRAUMA DURING CAESAREAN RATHER THAN ISCHEMIC INJURY DURING OBSTRUCTED LABOR. |
| Category | Education |
| Tags | VVF | VESICOVAGINAL FISTULA | COMPLEX FISTULA | UROGENITAL FISTULA IN WOMEN | LAPAROSCOPIC VVF REPAIR | LAPAROSCOPY | KEYHOLE SURGERY | MINIMALLY INVASIVE VVF REPAIR |
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