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Vesico-vaginal fistula post cold cup bladder biopsy: mini review.

Mawhinney A, Hameed A, Thwaini A, Mulholland C - Open Access J Urol (2010)

Bottom Line: A case of low grade superficial bladder cancer was treated with multiple resections of bladder tumor and a single installation of mitomycin post initial resection which successfully cleared her bladder cancer, but nevertheless led to a small size and scarred bladder.In addition there was a long history of smoking with its effects on tissue integrity and healing.The rate of successful fistula repair reported in the literature varies between 70% and 100% in nonradiated patients, with similar results when a vaginal or abdominal approach is performed, the mean success rates being 91% and 97%, respectively.

View Article: PubMed Central - PubMed

Affiliation: Belfast City Hospital, Urology Department, Belfast, Northern Ireland, UK.

ABSTRACT

Introduction: We report a case of a vesico-vaginal fistula (VVF) post cold cup biopsy; to our knowledge this is the only reported case. We present the clinical history/presentation, investigation and the outcome of the treatment. VVFs are among the most distressing complications of gynecologic and obstetric procedures. The risk of developing a VVF is more than 1% after radical surgery and radiotherapy for malignancies. Management of these fistulas has been better defined and standardized over the last decade.

Methods and results: A case of low grade superficial bladder cancer was treated with multiple resections of bladder tumor and a single installation of mitomycin post initial resection which successfully cleared her bladder cancer, but nevertheless led to a small size and scarred bladder. In addition there was a long history of smoking with its effects on tissue integrity and healing. VVFs are very rare and are an unpleasant outcome post a cold cup biopsy, adding to the psychological and social effects of the surgical treatment.

Conclusion: Although cold cup biopsy is a normal day procedure performed by both residents and consultants, consensus should exist on how to treat a patient who has a bladder with defective integrity and small capacity. The rate of successful fistula repair reported in the literature varies between 70% and 100% in nonradiated patients, with similar results when a vaginal or abdominal approach is performed, the mean success rates being 91% and 97%, respectively.

No MeSH data available.


Related in: MedlinePlus

Algorithm of vesico-vaginal fistula repair.
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f3-oaju-2-171: Algorithm of vesico-vaginal fistula repair.

Mentions: A classical transabdominal repair of the VVF was performed. The bladder was bivalved in the midline position, down to the level of the VVF. Both ureteric orifices were identified at the time of the procedure and were catheterized intraoperatively through the cystotomy incision (Figure 3).


Vesico-vaginal fistula post cold cup bladder biopsy: mini review.

Mawhinney A, Hameed A, Thwaini A, Mulholland C - Open Access J Urol (2010)

Algorithm of vesico-vaginal fistula repair.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3818888&req=5

f3-oaju-2-171: Algorithm of vesico-vaginal fistula repair.
Mentions: A classical transabdominal repair of the VVF was performed. The bladder was bivalved in the midline position, down to the level of the VVF. Both ureteric orifices were identified at the time of the procedure and were catheterized intraoperatively through the cystotomy incision (Figure 3).

Bottom Line: A case of low grade superficial bladder cancer was treated with multiple resections of bladder tumor and a single installation of mitomycin post initial resection which successfully cleared her bladder cancer, but nevertheless led to a small size and scarred bladder.In addition there was a long history of smoking with its effects on tissue integrity and healing.The rate of successful fistula repair reported in the literature varies between 70% and 100% in nonradiated patients, with similar results when a vaginal or abdominal approach is performed, the mean success rates being 91% and 97%, respectively.

View Article: PubMed Central - PubMed

Affiliation: Belfast City Hospital, Urology Department, Belfast, Northern Ireland, UK.

ABSTRACT

Introduction: We report a case of a vesico-vaginal fistula (VVF) post cold cup biopsy; to our knowledge this is the only reported case. We present the clinical history/presentation, investigation and the outcome of the treatment. VVFs are among the most distressing complications of gynecologic and obstetric procedures. The risk of developing a VVF is more than 1% after radical surgery and radiotherapy for malignancies. Management of these fistulas has been better defined and standardized over the last decade.

Methods and results: A case of low grade superficial bladder cancer was treated with multiple resections of bladder tumor and a single installation of mitomycin post initial resection which successfully cleared her bladder cancer, but nevertheless led to a small size and scarred bladder. In addition there was a long history of smoking with its effects on tissue integrity and healing. VVFs are very rare and are an unpleasant outcome post a cold cup biopsy, adding to the psychological and social effects of the surgical treatment.

Conclusion: Although cold cup biopsy is a normal day procedure performed by both residents and consultants, consensus should exist on how to treat a patient who has a bladder with defective integrity and small capacity. The rate of successful fistula repair reported in the literature varies between 70% and 100% in nonradiated patients, with similar results when a vaginal or abdominal approach is performed, the mean success rates being 91% and 97%, respectively.

No MeSH data available.


Related in: MedlinePlus