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Scientific Reports Jul 2022Magnetic compression technique (MCT) is a popular new anastomosis method. In this paper, we aimed to explore the feasibility of use of MCT for performing cystotomy in...
Magnetic compression technique (MCT) is a popular new anastomosis method. In this paper, we aimed to explore the feasibility of use of MCT for performing cystotomy in rabbits. The parent magnets and daughter magnets for rabbit cystostomy were designed and manufactured according to the anatomical characteristics of rabbit lower urinary tract. Twelve female New Zealand rabbits were used as animal models. After anesthesia, a daughter magnet was inserted into the bladder through the urethra, and the parent magnet was placed on the body surface projection of the bladder over the abdominal wall. The two magnets automatically attract each other. Postoperatively, the state of magnets was monitored daily, and the time when the magnets fell off was recorded. Cystostomy with MCT was successfully performed in all twelve rabbits. The mean operation time was 4.46 ± 0.75 min. The magnets fell off from the abdominal wall after a mean duration of 10.08 ± 1.62 days, resulting in the formation of bladder fistula. Macroscopic and microscopic examination showed that the fistula was well formed and unobstructed. The junction between bladder and abdominal wall was tight and smooth. We provide preliminary experimental evidence of the safety and feasibility of cystostomy based on MCT.
Topics: Animals; Cystostomy; Female; Magnetic Phenomena; Magnetics; Magnets; Pressure; Rabbits
PubMed: 35842556
DOI: 10.1038/s41598-022-16595-4 -
BMC Surgery May 2021Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and the nature of the fistula. There is still a lack of consensus regarding the if, when and how to repair the fistula. The aim of the study is to review the different surgical treatment options, focus on surgical indications, and explore cumulative recurrence, morbidity, and mortality rates of entero-vesical and colo-vesical fistula patients.
METHODS
A systematic review of the literature was conducted according to PRISMA guidelines. Random effects meta-analyses of proportions were developed to assess primary and secondary endpoints. I statistic and Cochran's Q test were computed to assess inter-studies' heterogeneity.
RESULTS
Twenty-two studies were included in the analysis with a total of 861 patients. Meta-analyses of proportions pointed out 5, 22.2, and 4.9% rates for recurrence, complications, and mortality respectively. A single-stage procedure was performed in 75.5% of the cases, whereas a multi-stage operation in 15.5% of patients. Palliative surgery was performed in 6.2% of the cases. In 2.3% of the cases, the surgical procedure was not specified. Simple and advanced repair of the bladder was performed in 84.3% and 15.6% of the cases respectively.
CONCLUSIONS
Although burdened by a non-negligible rate of complications, surgical repair of entero-colovesical fistula leads to excellent results in terms of primary healing. Our review offers opportunities for significant further research in this field. Level of Evidence Level III according to ELIS (SR/MA with up to two negative criteria).
Topics: Colon; Humans; Intestinal Fistula; Prevalence; Urinary Bladder Fistula
PubMed: 34044862
DOI: 10.1186/s12893-021-01272-6 -
Female Pelvic Medicine & Reconstructive... 2016To describe a case presentation and perform a review of the literature on vesicosalpingo fistulas. (Review)
Review
OBJECTIVES
To describe a case presentation and perform a review of the literature on vesicosalpingo fistulas.
METHODS
An otherwise healthy 32 year-old patient was referred to urology with symptoms of persistent abdominal bloating and urine leakage from the vagina after abdominal conversion of laparoscopic hysterectomy. Two fistula tracts were identified in the bladder during preoperative cystoscopy. The tracts were cannulated with temporary ureteral catheters, and the patient underwent a robotic-assisted laparoscopic repair of a vesicosalpingo and a vesicovaginal fistula.
RESULTS
The patient was discharged on the first postoperative day with an indwelling urinary catheter. A follow-up cystogram performed on the 14th postoperative day demonstrated no evidence of extravasation. There was no evidence of recurrence at a 4-month follow-up visit. This is the first reported robot-assisted laparoscopic repair of a vesicosalpingo fistula and the fifth reported case of a vesicosalpingo fistula in the literature. This is the first reported case of separate vesicosalpingo and vesicovaginal fistulas presenting concurrently in a single patient.
CONCLUSIONS
This case presentation with 2 separate fistula tracts emanating from the bladder demonstrates the need to meticulously evaluate each individual fistula tract in order to successfully visualize and address all fistula tracts present in order to mitigate failures and the need for reoperation.
Topics: Adult; Conversion to Open Surgery; Cystoscopy; Fallopian Tube Diseases; Female; Fistula; Humans; Hysterectomy; Laparoscopy; Postoperative Complications; Robotic Surgical Procedures; Urinary Bladder Fistula; Vesicovaginal Fistula
PubMed: 27403752
DOI: 10.1097/SPV.0000000000000297 -
The Pan African Medical Journal 2014
Topics: Adult; Cesarean Section; Cystoscopy; Female; Fistula; Hematuria; Humans; Urinary Bladder Fistula; Uterine Diseases
PubMed: 25400861
DOI: 10.11604/pamj.2014.18.94.4401 -
Annals of the Royal College of Surgeons... Jul 1987The experience of 66 cases of colovesical fistula is reported. The most common cause was diverticular disease (71%), the remainder being due to malignancy, Crohn's...
The experience of 66 cases of colovesical fistula is reported. The most common cause was diverticular disease (71%), the remainder being due to malignancy, Crohn's disease, radiotherapy, appendicitis and trauma. The most sensitive investigation was barium enema, which was abnormal in 98% and actually showed the fistula in 57%. In 32 patients a single stage resection was performed, without mortality or significant morbidity and we would advocate this form of treatment for fistulae which are not complicated by gross sepsis or obstruction.
Topics: Colon; Colonic Diseases; Female; Humans; Intestinal Fistula; Male; Urinary Bladder; Urinary Bladder Fistula
PubMed: 3631873
DOI: No ID Found -
Taiwanese Journal of Obstetrics &... Jan 2019Vesicovaginal fistulas (VVF) are consequences from obstetric and gynecologic surgery. Treatment approach from either abdominal or vaginal route have its own pros and...
OBJECTIVE
Vesicovaginal fistulas (VVF) are consequences from obstetric and gynecologic surgery. Treatment approach from either abdominal or vaginal route have its own pros and cons. The study aims to present the anatomical, clinical and lower urinary tract symptom outcomes of women with VVF.
MATERIALS AND METHODS
A retrospective case series conducted patients with VVF. Data regarding pre-operative evaluation, surgical treatment, and post-operative follow-ups were collected. Surgical approach depended on the cause, type, number, size, location, and time of onset of the fistula. Post-operatively, foley catheter was maintained for at least 1 week with cystoscopy performed prior to removal. Follow-up evaluation included cystoscopy, bladder diary, UDI-6 and IIQ-7 questionnaires and multi-channel urodynamic study.
RESULTS
Of the 15 patients that were evaluated, 1 had spontaneous closure, 8 were repaired vaginally and 6 abdominally. Patients repaired vaginally were significantly noted to have a mean age of 50.3 ± 7.1 years with VVFs located adjacent the supra-trigone area having a mean distance of 1.7 ± 0.5 cm from the ureteric orifice. Its operative time and hospital stay were significantly shorter. In contrast, abdominally repaired patients had mean age of 38.0 ± 8.2 years and VVFs with mean distance of 0.4 ± 0.4 cm from the ureteric orifice. Post-operatively, 2 cases (14.2%, 2/14) of VVF recurrence and de novo urodynamic stress incontinence (USI) (25%, 2/8) were noted after vaginal repair and 3 cases (50%, 3/6) of concurrent ureteric injury and overactive bladder after abdominal repair.
CONCLUSION
Treatment outcomes for vaginal and abdominal repair yielded good results. Though the vaginal route had higher incidence of recurrence and de novo USI, its less invasiveness, faster recovery period, and no association with post-op overactive bladder made it more preferable than the abdominal approach.
Topics: Adult; Female; Gynecologic Surgical Procedures; Humans; Middle Aged; Postoperative Complications; Retrospective Studies; Treatment Outcome; Urologic Surgical Procedures; Vesicovaginal Fistula
PubMed: 30638463
DOI: 10.1016/j.tjog.2018.11.021 -
Journal of the Royal Society of Medicine May 1992
Topics: Female; Humans; Prevalence; Vaginal Fistula; Vesicovaginal Fistula
PubMed: 1433083
DOI: 10.1177/014107689208500504 -
BMC Surgery Apr 2021Fistula formation due to mesh erosion into hollow viscera, such as the urinary bladder, is uncommon. To date, there have been no reports of fistula formation into the...
BACKGROUND
Fistula formation due to mesh erosion into hollow viscera, such as the urinary bladder, is uncommon. To date, there have been no reports of fistula formation into the urinary bladder without evidence of mesh erosion after hernioplasty; herein, we report one such rare case, in which the clinical symptoms improved without any surgical intervention.
CASE PRESENTATION
A 73-year-old man underwent a trans-abdominal preperitoneal repair for bilateral direct inguinal hernia. One month later, the patient experienced a painful induration in the right inguinal region, and computed tomography revealed fluid collection in this region. A culture of the aspirated fluid yielded no bacteria. Seven months later, he experienced another episode of painful induration in the same region. However, blood examination revealed a normal white blood cell count and C-reactive protein level. Moreover, no organisms were detected by aspirated fluid culture. Although the painful induration subsided after aspiration of the fluid collection, he developed gross hematuria and dysuria a month later. Cystoscopy revealed a fistula in the right wall of the urinary bladder that discharged a purulent fluid. Culture of the fluid revealed no bacteria, and there was no evidence of mesh erosion. Hematuria improved without therapeutic or surgical intervention. The patient's clinical symptoms improved without mesh removal. Moreover, cystoscopy revealed that the fistula was scarred 12 months after the initial appearance of urinary symptoms. No further complications were observed during a 42-month follow-up period.
CONCLUSIONS
We report a rare case of a fistula in the urinary bladder without evidence of mesh erosion after laparoscopic hernioplasty. The patient's condition improved without mesh removal. Fluid collection due to foreign body reaction to meshes can cause fistula formation in the urinary bladder without direct mesh contact.
Topics: Aged; Hernia, Inguinal; Herniorrhaphy; Humans; Laparoscopy; Male; Urinary Bladder Fistula
PubMed: 33827542
DOI: 10.1186/s12893-021-01183-6 -
BMC Surgery Jul 2019Enterovesical fistula (EVF) is a abnormal connection between the intestine and the bladder. The aim of the study was to analyze whether closure of the defect in the...
BACKGROUND
Enterovesical fistula (EVF) is a abnormal connection between the intestine and the bladder. The aim of the study was to analyze whether closure of the defect in the bladder wall during surgery is always necessary.
METHODS
Fifty-nine patients with benign EVF undergoing surgical treatment were enrolled. A one-stage surgical procedure was performed in all patients. After the separation of the diseased bowel segment, methylene blue was introduced. Through a catheter into the bladder. Only patients with urinary bladder leakage were sutured.
RESULTS
The most common intestinal fistula involving the urinary bladder was colovesical fistula, observed in 53% of cases. Two-thirds of patients had diverticular disease as the underlying pathology. There was no relationship between suturing of the bladder and perioperative complications. Recurrent EVF was observed in one patient with bladder suturing and in two patients without suture.
CONCLUSIONS
These findings suggest that closure of the bladder defect is not necessary in cases where a leak is not demonstrated from the bladder intraoperatively. This study is limited by its retrospective design and small numbers and a randomized controlled trial is recommended to answer this question definitively.
Topics: Adult; Aged; Female; Humans; Intestinal Fistula; Male; Middle Aged; Retrospective Studies; Suture Techniques; Urinary Bladder; Urinary Bladder Fistula
PubMed: 31286905
DOI: 10.1186/s12893-019-0542-4 -
BMC Urology Jun 2022Ileal neobladder fistula is a rare complication after radical cystectomy, with an incidence of approximately 0.7%. At present, there are scattered reports of vesicoileal...
BACKGROUND
Ileal neobladder fistula is a rare complication after radical cystectomy, with an incidence of approximately 0.7%. At present, there are scattered reports of vesicoileal fistula, but there are no reports of ileal neobladder fistula (INF) caused by bladder stones. In this paper, a case of ileal neobladder fistula caused by chronic stimulation of bladder stones was successfully diagnosed and treated.
CASE PRESENTATION
A 68-year-old man who had undergone radical cystectomy and an orthotopic ileal neobladder procedure 10 years prior presented with refractory diarrhoea and oliguria and was diagnosed with ileal neobladder fistula caused by chronic stimulation of bladder stones. We performed fistulectomy, cystotomy, partial ileectomy, and end-to-end ileal anastomosis, and the patient recovered and was discharged after the operation.
CONCLUSION
Urinary calculi are delayed complications of orthotopic neobladder construction after total cystectomy. Bladder stones are a rare complication of ileal neovesical fistula, which can cause neovesical cutaneous fistula. It is difficult to diagnose through routine examination and easily misdiagnosed as acute gastroenteritis. Surgery is an effective treatment for INF and can achieve a good prognosis.
Topics: Aged; Cystectomy; Humans; Ileum; Intestinal Fistula; Male; Urinary Bladder Calculi; Urinary Bladder Neoplasms; Urinary Diversion
PubMed: 35715838
DOI: 10.1186/s12894-022-01040-5