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Shwu-Shiuang Chen Shwu-Huey Yang Jenn-Ming Yang Wen-Chen Huang 《International urogynecology journal》2007,18(11):1381-1383
Ureterovaginal fistula is an uncommon but serious sequela of unrecognized distal ureteral injury during pelvic operations.
Traditionally, it is managed either by endoscopic internal ureteral stenting or by ureteral reimplantation. We report a case
of ureterovaginal fistula that failed to respond to ureteral stenting. Because the patient had a history of several laparotomies
and intra-abdominal abscesses, she was at high risk for complications with a transabdominal operation. Therefore, we used
transvaginal Latzko partial colpocleisis and successfully resolved the ureterovaginal fistula. 相似文献
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Ariel Zilberlicht Yuval Lavy Ron Auslender Yoram Abramov 《International urogynecology journal》2016,27(12):1925-1927
Introduction and hypothesis
Urethrovaginal fistula is a rare disorder that may occur following sling procedures for stress urinary incontinence, excision of a urethral diverticulum, anterior vaginal wall repair, radiation therapy, and prolonged indwelling urethral catheter. The most common clinical manifestation is continuous urinary leakage through the vagina, aggravated by an increase in the intra-abdominal pressure. Appropriate management, including timing of the surgical intervention and the preferred technique, remains controversial.Methods
This video presentation describes the transvaginal repair of a urethrovaginal fistula using the Latzko technique and a bulbocavernosus (Martius) flap.Results
The patient’s postoperative course was uneventful. At her follow-up visit 2 months later, she was free of urinary leakage, and a pelvic examination revealed excellent healing, with complete closure of the fistula.Conclusions
Transvaginal repair using the Latzko technique with a vascular bulbocavernosus (Martius) flap is an effective and safe mode of treatment.3.
Olivia Cardenas-Trowers John Heusinkveld Kenneth Hatch 《International urogynecology journal》2018,29(5):767-769
Introduction and hypothesis
The incidence of vesico-vaginal fistulas after hysterectomies for benign indications in developed countries is less than one percent. The objective of this video is to demonstrate an easy-to-follow, step-by-step approach to repairing a small, uncomplicated vesico-vaginal fistula transvaginally using a modified Latzko technique.Methods
In this video, we present a case of a 46-year-old woman who developed a simple, uncomplicated vesico-vaginal fistula after a total abdominal hysterectomy. To correct her fistula, we used a modified Latzko technique, which is a transvaginal approach to vesico-vaginal fistula repair that involves mobilizing the vaginal mucosa around the fistula and then closing the pubo-vesical fascia and vaginal mucosa in layers.Results
The patient had successful surgical correction of her vesico-vaginal fistula without recurrence of the fistula.Conclusions
For small, uncomplicated vesico-vaginal fistulas, a transvaginal approach has an equivalent success rate to that of other approaches with less invasiveness and faster recovery times. Therefore, it is reasonable to use a modified Latzko technique to help restore the quality of life to women affected by small, uncomplicated vesico-vaginal fistulas.4.
Latzko repair is a technique described for repair of post-hysterectomy supratrigonal vesicovaginal fistulas (VVF) and is often
practised by gynecologists, but it has not figured in the armamentarium of urologists the world over. Recently urologists
have taken to laparoscopic repair of such fistula but laparoscopic repair is technically demanding with a steep learning curve.
We reviewed our experience with the technique of Latzko repair. The study is a review of 10 patients operated by this technique
between June 2000 and May 2005, with age ranging from 33 to 55 years (average 39 years). Fistula size ranged from 2 mm to
1 cm. There was no recurrence or sexual dysfunction due to shortening of vaginal length. The results were comparable with
laparoscopic VVF repair in terms of morbidity, operative time, blood loss, and patient discomfort. Also, the learning curve
involved is minimal. Thus this technique deserves wider adoption by the urological community and should be a benchmark for
comparison with laparoscopic repair of VVF rather than the abdominal approach. Bearing in mind the simplicity of the procedure,
urologists should feel encouraged to adopt this excellent age-old technique that has stood the test of time rather than exploring
more-complex operations such as laparoscopic VVF repair and transurethral suture cystorrhaphy. 相似文献
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A technique for the repair of recto-urethral fistula 总被引:2,自引:0,他引:2
VOSE SN 《The Journal of urology》1949,61(4):790-794
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Tracheoinnominate artery fistula is a relatively rare but highly lethal complication for long-term tracheostomy patients that occurs with an estimated incidence of 1 out of every 150 tracheostomies performed. Appropriate operative technique during tracheostomy and meticulous postoperative care usually prevent this devastating lesion. When tracheoinnominate fistula is suspected, immediate evaluation under general anesthesia in the operating suite, followed by prompt thoracotomy and repair, is essential for the survival of these patients. 相似文献
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Vesicovaginal fistula: an effective technique of repair 总被引:1,自引:0,他引:1
SARGENT JC 《The Journal of urology》1955,73(3):520-524
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PURPOSE: We describe the technique of laparoscopic repair of post-cesarean cervicovesical fistula. MATERIALS AND METHODS: Two patients 30 and 35 years old, respectively, presented with urinary incontinence, amenorrhea and menouria. Both patients had undergone previously a second cesarean section. Diagnosis was post-cesarean cervicovesical fistula, which was repaired laparoscopically. RESULTS: Laparoscopic repair was successfully completed in 1 patient. In the other case, after complete dissection of the fistula and preparation of the edges for suturing, surgery had to be converted to an open procedure due to inability to maintain a pneumoperitoneum. CONCLUSIONS: Laparoscopy is a viable option for the repair of post-cesarean cervicovesical fistula with all its attendant advantages. 相似文献
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Narasimhan KL Mohanty SK Singh N Samujh R Rao KL Mitra SK 《Journal of pediatric surgery》1999,34(3):461-463
PURPOSE: The results of epispadias repair using Mitchell's technique in nine patients is analyzed and the advantages of the procedure discussed. METHODS: Nine boys aged between 6 weeks and 6 years underwent epispadias repair between November 1996 and March 1998 (Penopubic epispadias, inferior vesical fissure, and midpenile epispadias, one patient each; exstrophy epispadias complex, six patients). Eight patients had first attempt at repair of epispadias. Two patients had closure of exstrophy and epispadias at one stage. RESULTS: At a mean follow-up of 10 months, all children had a conical glans, eight patients had ventral orthotopic meatus, and one had coronal hypospadiac meatus. Minor penopubic fistula developed in one patient. Six patients had downward angled penis, and three had horizontal penis in a flaccid state. All children were observed to have good erections during sleep. CONCLUSIONS: Mitchell's technique of epispadias repair allows an anatomic reconstruction of the penis with superior cosmetic and functional results. Long-term follow-up studies are necessary to evaluate the genital functions. 相似文献
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Erik D. Hokenstad Ziyad S. Hammoudeh Nho V. Tran Heidi K. Chua John A. Occhino 《International urogynecology journal》2016,27(6):965-967
Introduction and hypothesis
This video demonstrates a technique for using a pedicled gracilis muscle flap to repair rectovaginal fistula.Methods
We present the case of a 48-year-old woman diagnosed with rectal cancer 2 years earlier. She underwent neoadjuvant chemoradiation followed by ultralow anterior resection. Six weeks after surgery, a fistula was identified at the anastomotic site. Preoperative planning with urogynecology, plastic surgery, and colon and rectal surgery teams deemed a pedicled gracilis muscle flap to be the best approach for this patient due to the rich blood supply and the patient’s prior history of pelvic irradiation. The gracilis muscle is suitable due to the proximity of its vascular pedicle to the perineum, length, and minimal functional donor-site morbidity. We discuss techniques used to interpose a gracilis muscle flap between the rectum and vagina to repair a rectovaginal fistula.Conclusion
Using the gracilis muscle is a viable option for repairing rectovaginal fistulas, especially in the setting of prior pelvic radiation. A multispecialty approach may be beneficial in complex cases to determine the optimal approach for repair.18.
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不留置导尿管修复尿道瘘 总被引:3,自引:0,他引:3
目的 总结不留置导尿管行尿道瘘修复的体会。方法 对37例尿道成形术后共50个尿道瘘采用2倍于尿道瘘创面附加局部皮瓣移转修复法,术后不插导尿管。结果 经7年临床实践,全获成功。结论 本法有可行性,并具有广泛的应用前景。 相似文献