This document discusses urogenital fistulas, including their classification, etiology, clinical manifestations, diagnosis, and treatment. It begins with an overview of urogenital fistulas as abnormal communications between the urinary and genital tracts. It then covers the various types of urinary and rectovaginal fistulas in more detail, along with their incidence, symptoms, diagnostic methods like cystoscopy, and surgical and conservative treatment approaches. The conclusion emphasizes the importance of early diagnosis and treatment to achieve good outcomes for patients with urogenital fistulas.
Clasificación colposcopica, criterios menores, criterios mayores, Rio de Janeiro 2011, Federación Internacional de Patología Cervical y tracto genital inferior
Se realiza una presentación explicando las características fundamentales del abdomen agudo ginecológico y sus diagnosticos diferenciales. se aportan principios terapéuticos y diagnósticos clínicos y de métodos complementarios.
Vesicouterine Fistula Following Cesarean Delivery – Ultrasound Diagnosis and ...Michelle Fynes
Vesicouterine fistulae are uncommon, with most units reporting 1–5 cases over 5–15 year periods. To date there has been a paucity of case reports regarding this problem and only a few case series. In this report we outline the presentation and management of a vesicouterine fistula complicating a repeat Cesarean delivery, specifically describing the role of transvaginal ultrasound.
Clasificación colposcopica, criterios menores, criterios mayores, Rio de Janeiro 2011, Federación Internacional de Patología Cervical y tracto genital inferior
Se realiza una presentación explicando las características fundamentales del abdomen agudo ginecológico y sus diagnosticos diferenciales. se aportan principios terapéuticos y diagnósticos clínicos y de métodos complementarios.
Vesicouterine Fistula Following Cesarean Delivery – Ultrasound Diagnosis and ...Michelle Fynes
Vesicouterine fistulae are uncommon, with most units reporting 1–5 cases over 5–15 year periods. To date there has been a paucity of case reports regarding this problem and only a few case series. In this report we outline the presentation and management of a vesicouterine fistula complicating a repeat Cesarean delivery, specifically describing the role of transvaginal ultrasound.
International Journal of Pharmaceutical Science Invention (IJPSI) inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Incisional Hernia Occurring after Ventriculoperitoneal Shunt Fixationsemualkaira
Ventriculo-peritoneal shunt is the procedure of choice for hydrocephalus. Various complications of ventriculoperitoneal shunts
were reported. Abdominal complications involving the distal tip
of the catheter make the majority of the complications. In this case
report we present a case of incisional hernia occurring in a patient
who underwent fixation of ventriculoperitoneal shunt followed by
revision of the shunt after a while.
Incisional Hernia Occurring after Ventriculoperitoneal Shunt Fixationsemualkaira
Ventriculo-peritoneal shunt is the procedure of choice for hydrocephalus. Various complications of ventriculoperitoneal shunts
were reported. Abdominal complications involving the distal tip
of the catheter make the majority of the complications. In this case
report we present a case of incisional hernia occurring in a patient
who underwent fixation of ventriculoperitoneal shunt followed by
revision of the shunt after a while.
Spontaneous rupture of endometriotic cyst in 3rd trimester of pregnancyApollo Hospitals
Endometriosis is a well established cause of female infertility and may be associated with early pregnancy losses. Association of endometriosis with pregnancy is rare. Ruptured endometriotic cyst presenting as acute abdomen in pregnancy is even a rarer presentation.
We present hereby a rare and interesting case, presented in our hospital, of Spontaneous rupture of endometiotic Cyst in 3rd trimester of pregnancy and its subsequent management.
Concurrent imperforate hymen and transverse vaginal septum: A rare presentati...Apollo Hospitals
A 13 year old girl not attained menarche presented as a case of acute abdomen; she had a mass per abdomen, on ultrasound diagnosed as haematometra and hematocolpus; clinically had an imperforate hymen; further evaluation by MRI revealed a high vaginal cause of obstruction which cannot be differentiated as vaginal atresia or a combination of transverse vaginal septum and imperforate hymen; operative findings showed a imperforate hymen with a patent lower vagina and a transverse vaginal septum separating upper and lower vagina; surgical correction done and drained 1000 ml of blood and post operatively patient is followed up for a month and bleeding through vagina during the next cycle is noted showing the patent vagina. This is a first case of concurrent transverse vaginal septum and imperforate hymen without any other genitourinary anomalies in literature.
This is a case report of a 69-year-old male who presented with chronic constipation, rectal pain. Laboratory reports revealed microcytic hypochromic anemia with iron deficiency. A colonoscopy showed the presence of an anal stricture with non-specific colitis. The patient was conservatively managed and sent to a hematologist for management of his anemia. After starting the patient on intravenous (IV) iron infusion, the patient’s symptoms resolved within 3 months.
Inducción del trabajo de parto.Indicaciones, utilidades, escala de bishop.
Oxitocina, prostaglandinas (misoprostol y dinoprostona), Indicaciones, contraindicaciones, complicaciones, efectos adversos. UMSNH
Lobulo parietal: Anatomia, generalidades, areas de brodman, areas de asociación, humunculo de Penfield, Correlaciones clinicas. Areas de brodman: 1,2,3,7. Circunvoluciones, limites.
Neurocisticercosis. Información actualizada sobre la epidemiologia, transmision, ciclo biologico, etapas, estudios de imagen y de laboratorio, así como actualización del tratamiento. Diagnosticos diferenciales. Prevención, medidas profilacticas. Datos basados en los sistemas de salud e nuestro país actualmente.
Cirugia. Definicion, usos, procedimientos, tratamientos, cancer de prostata, hiperplasia benigna prostatica. Tipos de cirugias, ureterorrenoscopia percutanea. Resección transuretral de prostata.
Introducción. Mecanismo de acción, variantes clinicas (otitis secretora, otitis media aguda, otitis media aguda recidivante, perforación timpanica cronica, mastoiditis aguda, otitis media crónica simple), microbiologia de la otitis media, tratamiento, tramiento de la otitis media aguda y cronica.
Tumores oseos 2. Benignos, malignos, metastasicos, diagnostico, tratamiento, manifestaciones clinicas, clasificacion, estudios de laboratorio. Quimioterapia, radioterapia, cirugia radical. Esta exposición es la original, muestra la parte 1 y 2 juntas. Esta tiene como finalidad que se muestre sola, las otras dos son para que se expongan de forma separada (proyectando), se complementan. Literatura base: Salter de TyO.
Tumores oseos 2. Benignos, malignos, metastasicos, diagnostico, tratamiento, manifestaciones clinicas, clasificacion, estudios de laboratorio. Quimioterapia, radioterapia, cirugia radical. Primera parte del tema, se complementa con la siguiente exposición, solo se muestran las letras, en la parte 2. Estan las imagenes.
Caso clínico sobre paciente con preeclampsia, diagnósticos y manejo intrahospitalario,
Comparación del tratamiento dado en el hospital contra el indicado por la guia de practica clinica y un articulo de Costa Rica.
Resumen de la guía de practica clínica: Prevención, diagnostico y tratamiento de la preeclampsia en segundo y tercer nivel de atencion.
Tratamiento con antihipertensivos, dosis, indicaciones, transfusión de plaquetas.
Algoritmo de manejos de una paciente con diagnostico de preeclampsia.
Norma oficial mexicana, clasificacion de los sucedaneos, caracteristicas especiales de cada una, uso medico, contenido de proteinas, carbohidratos, grasas, vitaminas, nutrimentos inorganicos, criterios microbiologicos.
Clinica quirurgica 3: Historia, Clasificacion de la obstruccion, definicion, epidemiologia, factores de riesgo, fisiopatologia, etiologia, semiologia del dolor, caracteristicas de los diferentes tipos de obstruccion, exploracion fisica, diagnostico, diagnostico diferenciales, manejo inicial del paciente, tratamiento, complicaciones, imagenes.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
1. UNIVERSIDAD MICHOACANA DE SAN NICOLAS DE HIDALGO
FACULTAD DE CIENCIAS MÉDICAS Y BIOLÓGICAS “DR.
IGNACIO CHAVEZ”
FISTULA UROGENITAL
PATOLOGÍA QUIRÚRGICA III
Dr. Abraham Jacobo Jacobo
David Linares González
Sección 09 5to año
Matrícula 1421183H
2. OBJETIVOS
Conocer los distintos tipos de fistulas urogenitales.
Conocer las diferentes clasificaciones.
Comprender la etiologia.
Identificar las manifestaciones clínicas y los métodos de diagnostico.
Conocer los diferentes tipos de tratamientos.
3. HISTORIA
Van Roonhuyse
siglo XVII.
1839, Haywayrd,
describió
separación de la
mucosa vesical
de la pared
vaginal.
1846, Metzer,
descubrió un
especulo.
1852, Sims,
primer trabajo
de tx.
1893, Von
Dittel, primer
corrección
transperitoneal.
1896, Kelly,
liberar vejiga
del cérvix.
1914, Latzko,
procedimiento
de tx FVV.
Usandizaga J, Fuente Pérez P. Obstetricia y ginecología. Patologia organica no tumoral. Fistulas genitourinrias y
genitointestinales.Capitulo 22, pagina 1004 Madrid: Marban; 2015.
4. FISTULAS UROGENITALES
La comunicación anormal entre las vías urinarias (ureteros, vejiga y
uretra) y los órganos genitales (útero, cuello uterino y vagina).
En condiciones anormales el útero o la vagina se pueden comunicar de forma
permanente con las vías urinarias o digestivas. Esta comunicación se denomina
fistula.
Williams, Ginecology, second edition. Genitourinary fistula. Chapter 26 page 677.
Usandizaga J, Fuente Pérez P. Obstetricia y ginecología. Patologia organica no tumoral. Fistulas genitourinrias y
genitointestinales.Capitulo 22, pagina 1004 Madrid: Marban; 2015.
6. CLASIFICACIÓN
Charles R.B. Beckmann, Frank W. Ling.Obstetrics and gynecology. Sixth Edition. Pelvic Support Defects, Urinary Incontinence,
and UrinaryTract Infection, chapter 28. page 263.
Hacker and Moore. Obstetrics and gynecology. Sixth Edition. Pelvic floor disorders. Urinary fistulas. Chapter23. Page 302
12. Frajzyngier V, Li G, Larson E, et al. Development and comparison of prognostic scoring systems for surgical closure of
genitourinary fistula.Am J Obstet Gynecol 2013;208:112.e1-11.
13. Frajzyngier V, Li G, Larson E, et al. Development and comparison of prognostic scoring systems for surgical closure of
genitourinary fistula.Am J Obstet Gynecol 2013;208:112.e1-11.
14. Frajzyngier V, Li G, Larson E, et al.
Development and comparison of
prognostic scoring systems for
surgical closure of genitourinary
15. Frajzyngier V, Li G, Larson E, et al.
Development and comparison of prognostic
scoring systems for surgical closure of
genitourinary fistula. Am J Obstet Gynecol
16. Frajzyngier V, Li G, Larson E, et al. Development and comparison of prognostic scoring systems for surgical closure of
genitourinary fistula.Am J Obstet Gynecol 2013;208:112.e1-11.
17. Frajzyngier V, Li G, Larson E,
et al. Development and
comparison of prognostic
scoring systems for surgical
closure of genitourinary
fistula. Am J Obstet Gynecol
18. Frajzyngier V, Li G, Larson
E, et al. Development and
comparison of prognostic
scoring systems for
surgical closure of
genitourinary fistula. Am J
19. Frajzyngier V, Li G,
Larson E, et al.
Development and
comparison of
prognostic scoring
systems for surgical
closure of genitourinary
20. Frajzyngier V, Li
G, Larson E, et
al. Development
and comparison
of prognostic
scoring systems
for surgical
closure of
genitourinary
fistula. Am J
21. Frajzyngier V, Li G, Larson E, et al. Development and comparison of
prognostic scoring systems for surgical closure of genitourinary fistula.
24. MANIFESTACIONES CLINICAS
La fístula vesicovaginal se presenta con escape continuo de orina inexplicable por la vagina después de una operación reciente.
En ocasiones, la salida intermitente de volúmenes pequeños de orina se confunde con incontinencia de esfuerzo posoperatoria. Otros
síntomas menos frecuentes incluyen fiebre, dolor, íleo e irritabilidad vesical.
La fístula vesicovaginal puede presentarse días o semanas después de la operación causante inicial, y las
que son subsiguientes a histerectomía casi siempre se manifiestan en una a tres semanas.
Algunas fístulas tienen periodos de latencia más prolongados y producen síntomas
varios años después.
Williams, Ginecology, second edition. Genitourinary fistula. Chapter 26 page 677.
25. FISTULAS URINARIAS
F. obstétrica F. vaginal F. Origen qx
Tx
fisioterápico
Canceres
genitales
González-Merlo. Novena edición. Enfermedades benignas de la vagina. Fistulas.
Hacker and Moore. Obstetrics and gynecology. Sixth Edition. Pelvic floor disorders. Urinary
fistulas. Chapter23. Page 302
27. SINTOMATOLOGÍA
Emisión involuntaria
y continua de orina
4-7 después del
parto
Por
instrumentos,
inmediatamente
González-Merlo. Novena edición. Enfermedades benignas de la vagina. Fistulas.
28. DIAGNOSTICO
HC
Dx dif: fistula
uretral y
vesical
Azul de
metileno
Fenazopiridina
Pielografia
descendente
Cistoscopia
González-Merlo. Novena edición. Enfermedades benignas de la vagina. Fistulas.
29. TRATAMIENTO
UVF: reimplantación del uréter en la vejiga
UVF y VVF:
No intervenir antes de los tres meses
Via de elección vaginal
Movilizar ampliamente los tej.
Drenaje urinario
Uso de esteroides
González-Merlo. Novena edición. Enfermedades benignas de la vagina. Fistulas.
30. FISTULA RECTOVAGINAL
Son trayectos recubiertos con epitelio, congénitos o adquiridos, entre la vagina y el recto.
Williams, Ginecology, second edition. Genitourinary fistula. Chapter 26 page 677.
Rectovaginal and Rectourethral Fistulas Joshua I.S. Bleier | Robert Caleb Kovell.
2015.
31. Williams, Ginecology, second edition. Genitourinary fistula. Chapter 26 pag
Rectovaginal and Rectourethral Fistulas Joshua I.S. Bleier | Robert
Caleb Kovell. 2015.
32. DIAGNOSTICO:
• HC
• Exploración física
• Pruebas dx: Enema con bario y TC
Williams, Ginecology, second edition. Genitourinary fistula. Chapter 26 pa
37. Vaginal Approach to Vesicovaginal Fistula Dominic Lee, FRACS (Urology)a, Philippe Zimmern, MD, FPMRSb,* Disclosure
Statement: None. a Department of Urology, St George Hospital, 28A Gray Street, Kogarah, New South Wales 2217, Australia; b
Department of Urology, UT Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, JA5- 130 C, Dallas, TX 75390-
38. Vaginal Approach to Vesicovaginal Fistula Dominic Lee, FRACS (Urology)a, Philippe Zimmern, MD, FPMRSb,* Disclosure
Statement: None. a Department of Urology, St George Hospital, 28A Gray Street, Kogarah, New South Wales 2217, Australia; b
Department of Urology, UT Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, JA5- 130 C, Dallas, TX 75390-
40. Vaginal Approach to Vesicovaginal Fistula. Dominic Lee, FRACS (Urology)a, Philippe Zimmern, MD, FPMRSb,* Disclosure
Statement: None. a Department of Urology, St George Hospital, 28A Gray Street, Kogarah, New South Wales 2217, Australia; b
Department of Urology, UT Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, JA5- 130 C, Dallas, TX 75390-
41. Vaginal Approach to Vesicovaginal Fistula Dominic Lee, FRACS (Urology)a, Philippe Zimmern, MD, FPMRSb,* Disclosure
Statement: None. a Department of Urology, St George Hospital, 28A Gray Street, Kogarah, New South Wales 2217, Australia; b
Department of Urology, UT Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, JA5- 130 C, Dallas, TX 75390-
42. Vaginal Approach to Vesicovaginal Fistula Dominic Lee, FRACS (Urology)a, Philippe Zimmern, MD, FPMRSb,* Disclosure
Statement: None. a Department of Urology, St George Hospital, 28A Gray Street, Kogarah, New South Wales 2217, Australia; b
Department of Urology, UT Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, JA5- 130 C, Dallas, TX 75390-
43. Vaginal Approach to Vesicovaginal Fistula Dominic Lee, FRACS (Urology)a, Philippe Zimmern, MD, FPMRSb,* Disclosure
Statement: None. a Department of Urology, St George Hospital, 28A Gray Street, Kogarah, New South Wales 2217, Australia; b
Department of Urology, UT Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, JA5- 130 C, Dallas, TX 75390-
44. Treatment of urogenital fistula in women C. Goktas, R. Horuz, G. Faydacı, A.C. Cetinel, O. Akc,a, S. Albayrak Urology Clinics,
KartalTraining and Research Hospital, Istanbul,Turkey
46. Vaginal Approach to Vesicovaginal Fistula Dominic Lee, FRACS (Urology)a, Philippe Zimmern, MD, FPMRSb,* Disclosure
Statement: None. a Department of Urology, St George Hospital, 28A Gray Street, Kogarah, New South Wales 2217, Australia; b
Department of Urology, UT Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, JA5- 130 C, Dallas, TX 75390-
47. COMPLICACIONES
Vaginal Approach to Vesicovaginal Fistula Dominic Lee, FRACS (Urology)a, Philippe Zimmern, MD, FPMRSb,* Disclosure
Statement: None. a Department of Urology, St George Hospital, 28A Gray Street, Kogarah, New South Wales 2217, Australia; b
Department of Urology, UT Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, JA5- 130 C, Dallas, TX 75390-
48. Usandizaga J, Fuente Pérez P. Obstetricia y ginecología. Patologia organica no tumoral. Fistulas genitourinrias y
genitointestinales.Capitulo 22, pagina 1004 Madrid: Marban; 2015.
49. CONCLUSIONES
La VVF es frecuente en países en vías de desarrollo.
La VVF son frecuentes en trabajos de parto prolongado y posterior a cirugía pélvica.
Las F. genitourinarias son más frecuentes que las rectovaginales.
La presentación clínica más importante de una fistula es la perdida involuntaria de orina posterior a una
cirugía pélvica o trabajo de parto prolongado.
La RVF se presentan con pérdida involuntaria de materia fecal por la vagina.
Es importante el seguimiento de una paciente posterior a un cirugía.
Realizar una buena HC, buscando antecedentes obstétricos, quirúrgicos y oncológicos.
Los métodos de diagnósticos más utilizados son la citoscopia y la uretrograma.
El tratamiento conservador tiene buenos resultados en fistulas de <1cm de diámetro.
El tratamiento transuretral para VVF tiene excelentes resultados.
El tratamiento definitivo para los trayectos fistulosos, complicados y que no funcionó el tratamiento
conservador, es quirúrgico.
50. BIBLIOGRAFÍA
Charles R.B. Beckmann, FrankW. Ling.Obstetrics and gynecology. Sixth Edition. Pelvic Support
Defects, Urinary Incontinence, and UrinaryTract Infection, chapter 28. page 263.
Williams,Ginecology, second edition. Genitourinary fistula. Chapter 26 page 677.
Hacker and Moore. Obstetrics and gynecology. Sixth Edition. Pelvic floor disorders. Urinary
fistulas.Chapter23. Page 302
Usandizaga J, Fuente Pérez P. Obstetricia y ginecología. Patologia organica no tumoral. Fistulas
genitourinrias y genitointestinales.Capitulo 22, pagina 1004 Madrid: Marban; 2015.
González-Merlo. Novena edición. Enfermedades benignas de la vagina. Fistulas. Capitulo 14,
pagina 257. Elsevier.
Atlas of urogynecological endoscopy. Peter L Dwyer. Urogenital Fistulae. Chapter 12. Page 127.