Genitourinary fistulas are abnormal connections between the urinary and genital tracts that cause involuntary urine leakage. The most common type is a vesicovaginal fistula between the bladder and vagina, usually resulting from prolonged obstructed labor without medical intervention. Symptoms include continuous urinary leakage from the vagina. Treatment involves identifying the fistula location and surgically repairing the tissues in layers with continuous bladder drainage via catheter. Success requires a single, small fistula without significant scarring or tissue loss.
Urethral stricture is an abnormal narrowing of the urethra caused by fibrosis and scarring from injury, infection, or inflammation. It occurs more often in males due to their longer urethra. Clinical features include dysuria, weak urine stream, urinary retention, and urinary tract infections. Management involves temporary measures like catheterization or definitive treatments like dilation, urethrotomy, or open urethroplasty depending on the location and severity of the stricture. Complications can include recurrent strictures, infections, fistulas, and renal impairment if left untreated.
This document discusses ureteric injuries that can occur during obstetric and gynecological surgeries and procedures for urinary diversions. It covers the anatomy of the ureters, risk factors for injury, types of injuries, prevention strategies, management approaches, and specific procedures like ileal conduits and continent urinary diversions. Nursing considerations are also outlined for preoperative teaching, postoperative care and monitoring, and potential complications from various urinary diversion surgeries.
This document discusses ureteric injury as a complication of gynecologic surgery. It covers the incidence, risk factors, applied anatomy of the pelvic ureter, common sites of injury, prevention strategies, and management approaches. Ureteric injury can occur in 0.03-6% of hysterectomies, with laparoscopic hysterectomy having the highest risk. The pelvic ureter has variable anatomy and is susceptible to injury at sites like the pelvic brim. Prevention focuses on proper identification and dissection of the ureter during surgery. Management depends on the severity and timing of injury but may involve stenting, urinary diversion, or ureteral reimplantation
This document discusses the principles of management of vesico-vaginal fistula (VVF). It begins with definitions and classifications of different types of fistulas. The main causes of VVF are discussed as obstructed labor and other obstetric complications. Clinical features include continuous urinary leakage. Surgical repair is the main treatment and involves excising scar tissue and closing the fistula in layers without tension. Factors like adequate drainage, preventing infection, and good surgical technique impact repair success.
This document provides an overview of ureteric injury in obstetrics and gynecological surgery. It discusses the anatomy of the pelvic ureter and risk factors for injury. Common sites of injury include at the pelvic brim and broad ligament. Injuries may be intraoperative such as crushing or transection, or postoperative like kinking. Prevention strategies include careful dissection and visualization of the ureter. Management depends on the timing, location and extent of injury, and may involve primary repair, ureteroureterostomy, or autotransplantation of the kidney. Stenting is often used to support healing after repair.
The document discusses different types of urogenital fistulas including their causes, presentations, diagnoses, and surgical repair techniques. It describes vesicovaginal, urethrovaginal, and ureterovaginal fistulas in detail, outlining their etiologies from obstetric trauma or surgery and treatments including surgical repairs via vaginal or abdominal approaches. Prevention strategies to avoid fistula formation during childbirth or gynecological procedures are also provided.
Genitourinary fistulas are abnormal connections between the urinary and genital tracts that cause involuntary urine leakage. The most common type is a vesicovaginal fistula between the bladder and vagina, usually resulting from prolonged obstructed labor without medical intervention. Symptoms include continuous urinary leakage from the vagina. Treatment involves identifying the fistula location and surgically repairing the tissues in layers with continuous bladder drainage via catheter. Success requires a single, small fistula without significant scarring or tissue loss.
Urethral stricture is an abnormal narrowing of the urethra caused by fibrosis and scarring from injury, infection, or inflammation. It occurs more often in males due to their longer urethra. Clinical features include dysuria, weak urine stream, urinary retention, and urinary tract infections. Management involves temporary measures like catheterization or definitive treatments like dilation, urethrotomy, or open urethroplasty depending on the location and severity of the stricture. Complications can include recurrent strictures, infections, fistulas, and renal impairment if left untreated.
This document discusses ureteric injuries that can occur during obstetric and gynecological surgeries and procedures for urinary diversions. It covers the anatomy of the ureters, risk factors for injury, types of injuries, prevention strategies, management approaches, and specific procedures like ileal conduits and continent urinary diversions. Nursing considerations are also outlined for preoperative teaching, postoperative care and monitoring, and potential complications from various urinary diversion surgeries.
This document discusses ureteric injury as a complication of gynecologic surgery. It covers the incidence, risk factors, applied anatomy of the pelvic ureter, common sites of injury, prevention strategies, and management approaches. Ureteric injury can occur in 0.03-6% of hysterectomies, with laparoscopic hysterectomy having the highest risk. The pelvic ureter has variable anatomy and is susceptible to injury at sites like the pelvic brim. Prevention focuses on proper identification and dissection of the ureter during surgery. Management depends on the severity and timing of injury but may involve stenting, urinary diversion, or ureteral reimplantation
This document discusses the principles of management of vesico-vaginal fistula (VVF). It begins with definitions and classifications of different types of fistulas. The main causes of VVF are discussed as obstructed labor and other obstetric complications. Clinical features include continuous urinary leakage. Surgical repair is the main treatment and involves excising scar tissue and closing the fistula in layers without tension. Factors like adequate drainage, preventing infection, and good surgical technique impact repair success.
This document provides an overview of ureteric injury in obstetrics and gynecological surgery. It discusses the anatomy of the pelvic ureter and risk factors for injury. Common sites of injury include at the pelvic brim and broad ligament. Injuries may be intraoperative such as crushing or transection, or postoperative like kinking. Prevention strategies include careful dissection and visualization of the ureter. Management depends on the timing, location and extent of injury, and may involve primary repair, ureteroureterostomy, or autotransplantation of the kidney. Stenting is often used to support healing after repair.
The document discusses different types of urogenital fistulas including their causes, presentations, diagnoses, and surgical repair techniques. It describes vesicovaginal, urethrovaginal, and ureterovaginal fistulas in detail, outlining their etiologies from obstetric trauma or surgery and treatments including surgical repairs via vaginal or abdominal approaches. Prevention strategies to avoid fistula formation during childbirth or gynecological procedures are also provided.
Radiological procedure of retrograde urethrography(rgu) and micturatingSanzzuTimilsina
MCU stands for Micturating Cystourethrography. It is a radiological examination of the urethra and bladder by injecting contrast medium through a catheter and imaging the urinary system during voiding.
The contrast medium is diluted in MCU to reduce the risk of adverse reactions from a highly concentrated agent being injected into the bladder.
Pre-warming the contrast medium to body temperature helps reduce spasms of the external urethral sphincter during the procedure.
Stress incontinence refers to involuntary leakage of urine during activities that increase abdominal pressure like coughing, sneezing, lifting etc.
RGU stands for Retrograde Urethrograph
The document provides information about the anatomy, blood supply, innervation and functions of the urinary bladder. It discusses the location of the bladder in the pelvis. It describes the parts of the bladder including the body, fundus, neck, apex and surfaces. It explains micturition and various factors involved in bladder filling and emptying. The document also discusses bladder injuries including risk factors, signs, management and repair techniques. It provides details about vesicovaginal fistula including causes, types, presentations and approaches to repair.
This document discusses genital tract fistulas, specifically defining them as abnormal communications between epithelial surfaces of the urinary and genital tracts. It classifies and describes different types of genital fistulas including genitourinary, intestinogenital, and skin-genital fistulas. The majority of the document focuses on vesicovaginal fistulas, discussing their causes, presentations, evaluations, and treatments. Prevention strategies are also outlined for obstetric and radiation-induced fistulas as well as surgical prevention techniques.
The document discusses genitourinary fistulas, which are abnormal connections between urinary and genital organs. It defines different types of fistulas including vesicovaginal, ureterovaginal, and urethrovaginal. The most common type is the vesicovaginal fistula, which is often caused by prolonged obstructed labor leading to tissue necrosis. Symptoms include urinary incontinence. Diagnosis involves history, examination for openings, and dye tests to locate the fistula. Management includes prevention of obstetric injuries, surgery to close openings, and postoperative catheterization.
This document provides biographic and clinical information for a 49-year-old female patient admitted with a diagnosis of vesico-vaginal fistula. It details her medical history, the cause of her fistula as an abdominal hysterectomy 3 months prior, and describes the diagnostic process and management plan. Vesico-vaginal fistula is defined as an abnormal connection between the bladder and vagina causing continuous involuntary discharge of urine. Surgical repair is usually successful, with various approaches available depending on the size and location of the fistula. The patient will receive antibiotic treatment and undergo surgical repair to close the fistula.
Obstetric fistula is an abnormal connection between the vagina and bladder or rectum caused by prolonged obstructed labor without timely medical intervention. Nigeria accounts for 40% of global fistula cases with around 20,000 new cases annually. Risk factors include poverty, early marriage, and lack of access to emergency obstetric care. Clinical presentation includes urinary or fecal incontinence. Treatment involves surgical repair once inflammation subsides, while prevention focuses on girl child education, empowerment, antenatal care, and emergency obstetric services.
This document provides information about urogynecological fistulas from the Department of Urology at Govt Royapettah Hospital and Kilpauk Medical College in Chennai. It discusses the different types of genitourinary fistulas including vesicovaginal fistula, their causes such as obstetric injuries or gynecological surgeries. Evaluation methods like cystoscopy and imaging are described. Conservative management and surgical repair techniques for fistulas via vaginal or abdominal approaches are outlined.
A presentation about Imaging the urinary tract using contrast.
contains 45 slides, and covers the following methods :
1 - Antegrade urography
2 - Retrograde urography
3 - Retrograde cystography
4 - Voiding cystography
5 - Retrograde Urethrography
Intravenous urography is covered in a separate presentation, that you can read and download from here :
http://www.slideshare.net/abdallamutwakil/intravenous-urography-ivu-35107052
This presentation was prepared and presented by me in the tutorials of the Radiology Department of Sebha Medical Center.
This document discusses genitourinary fistulas, including their classification, causes, symptoms, investigations, management, and prevention. The main types of fistulas are vesicovaginal, urethrovaginal, and ureterovaginal. Obstetric causes like obstructed labor are common in developing countries, while surgical trauma is more common in developed countries. Symptoms include continuous urine leakage. Investigations include dye tests and imaging. Management depends on the fistula type and complexity, and may involve surgical repair techniques like saucerization. Prevention focuses on adequate obstetric and surgical care to avoid injury.
The document discusses urinary incontinence, including its definition, types, causes, assessment, and treatment options. The main types of incontinence covered are stress, urge, mixed, overflow, and extra-urethral incontinence. Assessment involves history, physical exam including stress tests and pelvic floor strength tests, and investigations like urine tests, pad tests, uroflowmetry, and urodynamics. Treatment depends on the type but may include pelvic floor exercises, medications, bulking agents, slings, artificial sphincters, injections, and surgeries.
Management of ureteric injuries requires prompt diagnosis and repair to minimize complications. Ureteric injuries are most commonly caused by iatrogenic factors during surgeries near the ureters like hysterectomy. Diagnosis involves imaging like CT scans to detect contrast extravasation or hydronephrosis. Treatment depends on hemodynamic stability, with stable patients undergoing immediate primary repair and unstable patients getting temporary drainage first. Special circumstances like delayed diagnosis, endoscopic injuries, or fistulas may require additional measures like stenting. Surgical repairs aim to bridge defects with tension-free, spatulated anastomoses and stents to promote healing. Follow-up involves imaging and renal function tests to ensure patency.
This document discusses ureteric injuries that can occur during gynecological surgeries. It notes that the most common site of injury is near the pelvic brim at the infundibulopelvic ligament. The most common type of injury is obstruction and the most common cause is attempts to obtain hemostasis. It provides details on the anatomy of the ureter and risk factors for injury. Preventive strategies discussed include preoperative imaging, adequate exposure during surgery, and avoiding blind clamping of vessels near the ureter. Treatment depends on the severity, location, and timing of diagnosis of the injury. Options include conservative management, delayed repair, or immediate reoperation.
This document discusses rupture and retention of the urinary bladder. It describes the causes, symptoms, and treatments for intraperitoneal and extraperitoneal bladder rupture, which can result from direct trauma or surgery. Intraperitoneal rupture causes sudden severe pain and abdominal distension, while extraperitoneal rupture is difficult to distinguish from urethral rupture. Treatment involves draining the bladder and surgically repairing any tears. Retention of urine can be acute, due to blockages, or chronic, leading to overflow incontinence. Acute retention requires catheterization while chronic retention risks kidney damage and careful monitoring after drainage.
Urethral stricture is an abnormal narrowing of the urethra caused by fibrosis due to injury or inflammation. It is most common in males and usually occurs around age 50. Symptoms include poor urine stream and retention. Diagnosis involves tests like cystoscopy and retrograde urethrogram. Treatment depends on location and severity but may include dilation, internal urethrotomy, or open urethroplasty surgery to repair or bypass the stricture. Effective drainage of the bladder is important to manage this condition.
The document describes a case of a 40-year-old female patient presenting with symptoms of urinary and stool leakage from the vagina for 3 months and 1 month respectively, who is diagnosed with a vesicovaginal fistula based on physical examination findings of vaginal rents and investigations. It then provides details on the types, causes, evaluation, and management of vesicovaginal fistulas, the most common being those resulting from prolonged obstructed labor during childbirth in developing countries.
This document provides an overview of vesico-vaginal fistula (VVF), including its prevalence globally and in Nigeria, historical perspectives, causes, classifications, management approaches, prevention strategies, and VVF centers in Nigeria. It discusses that VVF is most common in Asia and Sub-Saharan Africa, with an estimated 50,000-100,000 new cases annually. Nigeria accounts for 40% of global VVF cases. The document outlines classifications of VVF based on anatomy, severity, and size. Surgical repair is the primary management approach and can be performed vaginally or abdominally depending on the fistula. Post-operative care and prevention strategies aimed at reducing poverty, illiteracy and harmful practices are also
This document discusses the anatomy, causes, diagnosis, and management of ureteric injuries.
The key points are:
1. The ureters have a close anatomical relationship with major vessels that can lead to injuries during surgery or trauma.
2. Ureteric injuries can occur during open or laparoscopic abdominal/pelvic surgeries, endoscopic procedures, or external trauma.
3. Diagnosis may be intraoperative or delayed, detected by imaging showing extravasation or hydronephrosis.
4. Management depends on the location and severity of injury, and may include ureteroureterostomy, transureteroureterostomy,
This document discusses the classification and management of genitourinary fistulas. It begins with an introduction defining a fistula and classifying them based on organ of origin and termination point in the urinary tract. It then describes various types of genitourinary fistulas involving the bladder, ureter, and urethra. The remainder of the document covers etiology, clinical features, investigations, prevention, and surgical and non-surgical management of genitourinary fistulas.
This document provides an overview of the history and techniques for orthotopic neobladder urinary diversion. Some key points:
- Orthotopic diversion was pioneered in the 1950s as an alternative to ureterosigmoidostomy and ileal conduit diversion due to complications of those procedures.
- Patient selection considers oncologic factors like risk of urethral recurrence and tumor stage, as well as patient factors like age, renal function, manual dexterity, and prior treatments.
- Surgical techniques aim to optimize continence by preserving the rhabdosphincter and its innervation during cystectomy. For males the urethra is detached in a retrograde
This document provides information on various gynecological procedures including hysterectomy, myomectomy, dilation and evacuation, cervical cerclage, hysteroscopy, and laparoscopy. It describes the procedures, indications, pre-procedure counseling elements, techniques, potential complications, and post-procedure care. Hysterectomy involves removal of the uterus, which can be total or subtotal. Myomectomy removes fibroids. Dilation and evacuation is used to diagnose conditions or remove retained pregnancy tissue. Cervical cerclage closes the cervix to prevent preterm birth. Hysteroscopy and laparoscopy allow internal visualization of the uterus and abdomen respectively.
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
More Related Content
Similar to الجديد.pptxhgffffffffffffgggggghhhjjjjjjkk
Radiological procedure of retrograde urethrography(rgu) and micturatingSanzzuTimilsina
MCU stands for Micturating Cystourethrography. It is a radiological examination of the urethra and bladder by injecting contrast medium through a catheter and imaging the urinary system during voiding.
The contrast medium is diluted in MCU to reduce the risk of adverse reactions from a highly concentrated agent being injected into the bladder.
Pre-warming the contrast medium to body temperature helps reduce spasms of the external urethral sphincter during the procedure.
Stress incontinence refers to involuntary leakage of urine during activities that increase abdominal pressure like coughing, sneezing, lifting etc.
RGU stands for Retrograde Urethrograph
The document provides information about the anatomy, blood supply, innervation and functions of the urinary bladder. It discusses the location of the bladder in the pelvis. It describes the parts of the bladder including the body, fundus, neck, apex and surfaces. It explains micturition and various factors involved in bladder filling and emptying. The document also discusses bladder injuries including risk factors, signs, management and repair techniques. It provides details about vesicovaginal fistula including causes, types, presentations and approaches to repair.
This document discusses genital tract fistulas, specifically defining them as abnormal communications between epithelial surfaces of the urinary and genital tracts. It classifies and describes different types of genital fistulas including genitourinary, intestinogenital, and skin-genital fistulas. The majority of the document focuses on vesicovaginal fistulas, discussing their causes, presentations, evaluations, and treatments. Prevention strategies are also outlined for obstetric and radiation-induced fistulas as well as surgical prevention techniques.
The document discusses genitourinary fistulas, which are abnormal connections between urinary and genital organs. It defines different types of fistulas including vesicovaginal, ureterovaginal, and urethrovaginal. The most common type is the vesicovaginal fistula, which is often caused by prolonged obstructed labor leading to tissue necrosis. Symptoms include urinary incontinence. Diagnosis involves history, examination for openings, and dye tests to locate the fistula. Management includes prevention of obstetric injuries, surgery to close openings, and postoperative catheterization.
This document provides biographic and clinical information for a 49-year-old female patient admitted with a diagnosis of vesico-vaginal fistula. It details her medical history, the cause of her fistula as an abdominal hysterectomy 3 months prior, and describes the diagnostic process and management plan. Vesico-vaginal fistula is defined as an abnormal connection between the bladder and vagina causing continuous involuntary discharge of urine. Surgical repair is usually successful, with various approaches available depending on the size and location of the fistula. The patient will receive antibiotic treatment and undergo surgical repair to close the fistula.
Obstetric fistula is an abnormal connection between the vagina and bladder or rectum caused by prolonged obstructed labor without timely medical intervention. Nigeria accounts for 40% of global fistula cases with around 20,000 new cases annually. Risk factors include poverty, early marriage, and lack of access to emergency obstetric care. Clinical presentation includes urinary or fecal incontinence. Treatment involves surgical repair once inflammation subsides, while prevention focuses on girl child education, empowerment, antenatal care, and emergency obstetric services.
This document provides information about urogynecological fistulas from the Department of Urology at Govt Royapettah Hospital and Kilpauk Medical College in Chennai. It discusses the different types of genitourinary fistulas including vesicovaginal fistula, their causes such as obstetric injuries or gynecological surgeries. Evaluation methods like cystoscopy and imaging are described. Conservative management and surgical repair techniques for fistulas via vaginal or abdominal approaches are outlined.
A presentation about Imaging the urinary tract using contrast.
contains 45 slides, and covers the following methods :
1 - Antegrade urography
2 - Retrograde urography
3 - Retrograde cystography
4 - Voiding cystography
5 - Retrograde Urethrography
Intravenous urography is covered in a separate presentation, that you can read and download from here :
http://www.slideshare.net/abdallamutwakil/intravenous-urography-ivu-35107052
This presentation was prepared and presented by me in the tutorials of the Radiology Department of Sebha Medical Center.
This document discusses genitourinary fistulas, including their classification, causes, symptoms, investigations, management, and prevention. The main types of fistulas are vesicovaginal, urethrovaginal, and ureterovaginal. Obstetric causes like obstructed labor are common in developing countries, while surgical trauma is more common in developed countries. Symptoms include continuous urine leakage. Investigations include dye tests and imaging. Management depends on the fistula type and complexity, and may involve surgical repair techniques like saucerization. Prevention focuses on adequate obstetric and surgical care to avoid injury.
The document discusses urinary incontinence, including its definition, types, causes, assessment, and treatment options. The main types of incontinence covered are stress, urge, mixed, overflow, and extra-urethral incontinence. Assessment involves history, physical exam including stress tests and pelvic floor strength tests, and investigations like urine tests, pad tests, uroflowmetry, and urodynamics. Treatment depends on the type but may include pelvic floor exercises, medications, bulking agents, slings, artificial sphincters, injections, and surgeries.
Management of ureteric injuries requires prompt diagnosis and repair to minimize complications. Ureteric injuries are most commonly caused by iatrogenic factors during surgeries near the ureters like hysterectomy. Diagnosis involves imaging like CT scans to detect contrast extravasation or hydronephrosis. Treatment depends on hemodynamic stability, with stable patients undergoing immediate primary repair and unstable patients getting temporary drainage first. Special circumstances like delayed diagnosis, endoscopic injuries, or fistulas may require additional measures like stenting. Surgical repairs aim to bridge defects with tension-free, spatulated anastomoses and stents to promote healing. Follow-up involves imaging and renal function tests to ensure patency.
This document discusses ureteric injuries that can occur during gynecological surgeries. It notes that the most common site of injury is near the pelvic brim at the infundibulopelvic ligament. The most common type of injury is obstruction and the most common cause is attempts to obtain hemostasis. It provides details on the anatomy of the ureter and risk factors for injury. Preventive strategies discussed include preoperative imaging, adequate exposure during surgery, and avoiding blind clamping of vessels near the ureter. Treatment depends on the severity, location, and timing of diagnosis of the injury. Options include conservative management, delayed repair, or immediate reoperation.
This document discusses rupture and retention of the urinary bladder. It describes the causes, symptoms, and treatments for intraperitoneal and extraperitoneal bladder rupture, which can result from direct trauma or surgery. Intraperitoneal rupture causes sudden severe pain and abdominal distension, while extraperitoneal rupture is difficult to distinguish from urethral rupture. Treatment involves draining the bladder and surgically repairing any tears. Retention of urine can be acute, due to blockages, or chronic, leading to overflow incontinence. Acute retention requires catheterization while chronic retention risks kidney damage and careful monitoring after drainage.
Urethral stricture is an abnormal narrowing of the urethra caused by fibrosis due to injury or inflammation. It is most common in males and usually occurs around age 50. Symptoms include poor urine stream and retention. Diagnosis involves tests like cystoscopy and retrograde urethrogram. Treatment depends on location and severity but may include dilation, internal urethrotomy, or open urethroplasty surgery to repair or bypass the stricture. Effective drainage of the bladder is important to manage this condition.
The document describes a case of a 40-year-old female patient presenting with symptoms of urinary and stool leakage from the vagina for 3 months and 1 month respectively, who is diagnosed with a vesicovaginal fistula based on physical examination findings of vaginal rents and investigations. It then provides details on the types, causes, evaluation, and management of vesicovaginal fistulas, the most common being those resulting from prolonged obstructed labor during childbirth in developing countries.
This document provides an overview of vesico-vaginal fistula (VVF), including its prevalence globally and in Nigeria, historical perspectives, causes, classifications, management approaches, prevention strategies, and VVF centers in Nigeria. It discusses that VVF is most common in Asia and Sub-Saharan Africa, with an estimated 50,000-100,000 new cases annually. Nigeria accounts for 40% of global VVF cases. The document outlines classifications of VVF based on anatomy, severity, and size. Surgical repair is the primary management approach and can be performed vaginally or abdominally depending on the fistula. Post-operative care and prevention strategies aimed at reducing poverty, illiteracy and harmful practices are also
This document discusses the anatomy, causes, diagnosis, and management of ureteric injuries.
The key points are:
1. The ureters have a close anatomical relationship with major vessels that can lead to injuries during surgery or trauma.
2. Ureteric injuries can occur during open or laparoscopic abdominal/pelvic surgeries, endoscopic procedures, or external trauma.
3. Diagnosis may be intraoperative or delayed, detected by imaging showing extravasation or hydronephrosis.
4. Management depends on the location and severity of injury, and may include ureteroureterostomy, transureteroureterostomy,
This document discusses the classification and management of genitourinary fistulas. It begins with an introduction defining a fistula and classifying them based on organ of origin and termination point in the urinary tract. It then describes various types of genitourinary fistulas involving the bladder, ureter, and urethra. The remainder of the document covers etiology, clinical features, investigations, prevention, and surgical and non-surgical management of genitourinary fistulas.
This document provides an overview of the history and techniques for orthotopic neobladder urinary diversion. Some key points:
- Orthotopic diversion was pioneered in the 1950s as an alternative to ureterosigmoidostomy and ileal conduit diversion due to complications of those procedures.
- Patient selection considers oncologic factors like risk of urethral recurrence and tumor stage, as well as patient factors like age, renal function, manual dexterity, and prior treatments.
- Surgical techniques aim to optimize continence by preserving the rhabdosphincter and its innervation during cystectomy. For males the urethra is detached in a retrograde
This document provides information on various gynecological procedures including hysterectomy, myomectomy, dilation and evacuation, cervical cerclage, hysteroscopy, and laparoscopy. It describes the procedures, indications, pre-procedure counseling elements, techniques, potential complications, and post-procedure care. Hysterectomy involves removal of the uterus, which can be total or subtotal. Myomectomy removes fibroids. Dilation and evacuation is used to diagnose conditions or remove retained pregnancy tissue. Cervical cerclage closes the cervix to prevent preterm birth. Hysteroscopy and laparoscopy allow internal visualization of the uterus and abdomen respectively.
Similar to الجديد.pptxhgffffffffffffgggggghhhjjjjjjkk (20)
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
How to Make a Field Mandatory in Odoo 17Celine George
In Odoo, making a field required can be done through both Python code and XML views. When you set the required attribute to True in Python code, it makes the field required across all views where it's used. Conversely, when you set the required attribute in XML views, it makes the field required only in the context of that particular view.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
हिंदी वर्णमाला पीपीटी, hindi alphabet PPT presentation, hindi varnamala PPT, Hindi Varnamala pdf, हिंदी स्वर, हिंदी व्यंजन, sikhiye hindi varnmala, dr. mulla adam ali, hindi language and literature, hindi alphabet with drawing, hindi alphabet pdf, hindi varnamala for childrens, hindi language, hindi varnamala practice for kids, https://www.drmullaadamali.com
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
Leveraging Generative AI to Drive Nonprofit InnovationTechSoup
In this webinar, participants learned how to utilize Generative AI to streamline operations and elevate member engagement. Amazon Web Service experts provided a customer specific use cases and dived into low/no-code tools that are quick and easy to deploy through Amazon Web Service (AWS.)
How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
2. Definition
• Abnormal communication between the urinary and
genital tract either acquired or congenital with
involuntary escape of urine into vagina.
6. What leads to fistula
• Obstetrics cause
Ischeiiiic
Obstructed labour
Traumatic
Instrumental vaginal
delivery
Destructive operation
Hysterectomy
7. Gynecological cause
Operative i iury: Colporrhaphy, Hysterectomy
Traumatic: Fall onsharp object , Fracture of pelvic bone,
Stick used for criminal abortion
Malignant: Cervix , Vagina , Bladder.
Infection : GTB , LGV, Schistosomiasis, Actinoinycosis.
8. Symptoms & Signs
• Continuous escape of
urine per vagina
• Gets urge but urine
dribbles out into the
vagina
• Secondary
ammenorrhoea
• Foot drop
• Vulval inspection
Aminoniacal smell
Evidences of sodden and
excoriation ofthe vulval
skin
Complete perineal tear or
RVF
11. Three swab test
Result of 3 swab test
1. Discolouration of topmost
or middle swab
vesicovaginal fistula
2. Uppermost swab wetting
but not discolouration
W Ureterovaginal fistula
3. Discolouration of lower most
swab but upper two swabs
remain dry
W Urethrovaginal fistula
12. Three swab test
Intravenous Urography
Retrograde pyelography
Cystograpliy
Sinography
(Fistulography)
Hysterosalpingography
USG, CT, MRI
CystDurethroscopy
Examination under
anaesthesia
Investigations
To differentiate from ureterovaginal and
urethrovaginal
Uirterovaginal fistula
Exact site of ureterovaginal fistula
Not routine. Vesicouterine
Intestinogenitalfistula
Vesicouterine
Complex fistula
Location of fistula iii relatiDn to ureteric
orifice
Identification of small fistula
13. Principles in the management (VVF)
• Detected during operation
Imrne‹tiate iepaii i:z two1ayei
• Detected in the postoperative period
Indivelling catheter foi io t 14NVQS
If fails i'epaii after 3 months
• Malignant or post radiation fistula
Ileal bladder
Anterior exenteration
Colpocleisis
• Infective fistula
Eradication of specific infection followed by local repair
15. Principle of ureteric repair
• Not to damage ureteric sheath and its blood supply
• Ureteric mobilization and tension free anastomosis
• Watertight closure
• Stent with ureteric catheter
• Passive drain at the anastomotic site to prevent urine
granuloma
16. Principle of ureteric repair
• During operation
Urethral sheath denudation
No intervention
Ureteral stenting (Double â, Pig tail)
Ureteral kinking
Immediate removal of suture
Uretei•al ligation
Immediate deligation
Ureteral stunting if required
Ureteral crushing
Stenting & extraperitonealdrainage
19. What you must remember
• Most common fistula
Developing corn tiice
VVF-- Obstetric
Uretencvaginal fistula —Trauma
• Identificationof high risk cases
• Utmost care during any pelvic procedure
• If detected during procedure
• If detected following procedure
• If fails —
repair after3 months
20. References
• Shaw ’s Text books of Gynaecology- i6th edition
• DCDutta's Text books of Gynaecology- 6th edtion
