Ultra-short bladder decompression in repaired vesico-vaginal fistulas (VVFs)
Journal Title: Indian Obstetrics & Gynaecology - Year 2016, Vol 6, Issue 1
Abstract
Purpose: To get rid of the morbidities incurred with prolonged use of trans urethral Foley catheter, supra-pubic Malecot catheter and intra-abdominal pelvic drain by doing ultra short decompression of bladder for three days using solitary wide bore 16 F Foley catheter in selected patients of repaired vesico vaginal fistulas (VVFs). Material and Methods: Five non-obese, medically fit and physically active women, aged between 35 and 40 years, presented with 3-15 years history of continuous leakage of urine per-vaginam after hysterectomies in four cases, prolonged and obstructed delivery in one case. All were counseled and consented for ultra short bladder decompression. Transabdominal transvesical repair was done in four patients and trans vaginal repair in one. Circum-dissection of fistula upto two centimeters was followed by tension free separate closure of bladder and vagina at right angle to each other in two layers, inner continuous and outer interrupted sutures using 2-0 vicryl on round bodied needle. Water tight closure of bladder was confirmed on operation table. Vigilant post-operative care was provided to all patients to ensure uninterrupted bladder decompression for first 72 hours and maintenance of adequate hydration. Once patients became fully active and ambulatory, the Foley catheter was removed and patients were advised to evacuate bladder every two hours without any straining. Results: All the patients had uneventful postoperative recovery and were fully continent at three months of follow-up. Conclusions: Ultra short bladder decompression would prevent various tubes and catheters related morbidities.
Authors and Affiliations
Dr . R B Singh, Dr K Singh, Dr S Nanda, Dr. S Dalal
Keywords
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