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Urology Case Reports Nov 2022Epididymo-orchitis is a common urological condition that can be caused by a variety of etiologies, including retrograde extension of a urinary tract infection....
Epididymo-orchitis is a common urological condition that can be caused by a variety of etiologies, including retrograde extension of a urinary tract infection. Colovesical fistulas are frequent sequelae of diverticulitis that allow for communication between the colon and urinary bladder. Such fistulas facilitate the spread of enteric bacteria into the urinary bladder, with possible subsequent spread throughout the rest of the genitourinary system. Retrograde extension into the epididymis and testis is very rare, however. We present the case of a 38 year old man with epididymo-orchitis secondary to a colovesical fistula.
PubMed: 36438455
DOI: 10.1016/j.eucr.2022.102281 -
Revista Brasileira de Ginecologia E... Sep 2018To describe a case of vesicouterine fistula and to review the literature related to this condition. (Review)
Review
OBJECTIVE
To describe a case of vesicouterine fistula and to review the literature related to this condition.
METHODS
For the review, we accessed the MEDLINE, BIREME and LILACS databases; the references of the searched articles were also reviewed.
RESULTS
A 38-year-old woman, in the 1st day after her 3rd cesarean, presented heavy hematuria, which was considered secondary to a difficult dissection of the bladder. A total of 6 months after delivery, she failed to resume her regular menstrual cycles and presented cyclic menouria and amenorrhea. At this time, she had two episodes of urethral obstruction by blood clots. She remained without a correct diagnosis until about two years postdelivery, when a vesicouterine fistula was confirmed through cystoscopy. A surgical correction through open abdominal route, coupled with hysterectomy, was performed. After the surgery, the symptoms disappeared. The review showed a tendency of change in the relative frequency of the different types of genitourinary fistulae. Vesicovaginal fistulae, usually caused by inadequate care during labor, are becoming less frequent than those secondary to medical procedures, such as vesicouterine fistulae. The most common cause of this latter kind of fistula is cesarean section, especially repeated cesarean sections. The diagnosis is confirmed through one or more imaging exams, or through cystoscopy. The most common treatment is surgical, and the routes are: open abdominal, laparoscopic, vaginal or robotic. There are some reports of success with the conservative treatment.
CONCLUSION
Vesicouterine fistulae are becoming more common because of the increase in the performance of cesarean sections, and the condition must be considered a possible complication thereof.
Topics: Adult; Cesarean Section; Female; Fistula; Humans; Postoperative Complications; Syndrome; Urinary Bladder Fistula; Uterine Diseases
PubMed: 30231295
DOI: 10.1055/s-0038-1666998 -
BMC Women's Health Jan 2019Obstetric fistula is an abnormal connection between the vagina and rectum and/or bladder, which leads to continuous urinary or fecal incontinence. It is a serious...
BACKGROUND
Obstetric fistula is an abnormal connection between the vagina and rectum and/or bladder, which leads to continuous urinary or fecal incontinence. It is a serious problem in the world poorest countries, where most mothers give birth without any medical care. In most cases obstetric fistula is preventable and can be treated successfully, if it is carried out by a competent surgeon with a good follow-up of postoperative care. However, there remains to explore more on the duration of obstetric fistula recovery and determinant factors. The aim of this study was to estimate the average recovery time of obstetric fistula and to identify its determinants in Gondar University teaching and referral hospital, northwest Ethiopia.
METHOD
A retrospective follow up study was conducted at Gondar University teaching and referral hospital. A total of 612 fistula cases were included in the study and simple random sampling technique was applied to select the study subjects. Kaplan-Meier and log rank test were computed to explore the data. Weibull regression survival model with univariate frailty was done to identify the determinant factors of time to recovery.
RESULTS
Of 612 fistula patients, 539(88.07%) were recovered. The Average (median) recovery time was 5.14 (IQR = 3.14, 9.14) weeks. Using Antibiotic (AHR = 1.49, 95% CI = 1.11-2.01), having history of antenatal care (ANC) (AHR = 1.95, 95% CI = 1.39-2.73), being literate (AHR = 2.23, 95% CI = 1.62-3.06), duration of bladder catheterization (AHR = 0.93, CI = 0.90-0.95) and being multiparous (AHR = 1.51, 95% CI = 1.17-1.96) were a significant predictors of the rate of recovery. Also, underweight (AHR = 0.45, 95% CI = 0.30-0.68), overweight (AHR = 0.56, 95% CI = 0.41-0.76), being obese (AHR = 0.41, 95% CI = 0.21-0.80), having extensive fistula (AHR = 0.82, 95% CI = 0.73-0.91), large fistula (AHR = 0.42, 95% CI = 0.23-0.78), medium width (AHR = 0.62, 95% CI = 0.43-0.91) and large width (AHR = 0.42, 95% CI = 0.23-0.78) were statistically significant predictors of the rate of recovery from fistula patients.
CONCLUSION
The average recovery time from obstetric fistula patients was 5.14 weeks. Small Length and width of fistula, patients' educational status (literacy), antibiotic use, history of antenatal care visits, normal BMI, short period catheterization and being multiparous were the significant determinate variables which shorten the recovery time of obstetric fistula.
Topics: Adult; Ethiopia; Female; Follow-Up Studies; Humans; Male; Middle Aged; Obstetric Labor Complications; Pregnancy; Prenatal Care; Recovery of Function; Referral and Consultation; Retrospective Studies; Risk Factors; Treatment Outcome; Vesicovaginal Fistula
PubMed: 30616532
DOI: 10.1186/s12905-018-0700-3 -
International Journal of Gynaecology... Jan 2020Thirteen years after the last supplement on obstetric fistula, the authors challenge the progress achieved. Citing the ongoing need for a standardized classification...
Thirteen years after the last supplement on obstetric fistula, the authors challenge the progress achieved. Citing the ongoing need for a standardized classification system, uniform surgical training and certification, evaluation, follow-up, and research, we emphasize the need for improved communication and coordination between government and nongovernment entities invested in ending obstetric fistula. Struck by the call by the United Nations to end obstetric fistula by 2030, we stress the need for increased and targeted funding of programs that are of the highest quality and impact.
Topics: Clinical Competence; Delivery, Obstetric; Female; Humans; International Cooperation; Obstetric Labor Complications; Obstetrics; Pregnancy; Vesicovaginal Fistula
PubMed: 31943187
DOI: 10.1002/ijgo.13032 -
Indian Journal of Public Health 2020Each year, between 50,000 and 100,000 women worldwide develop obstetric fistulae. Approximately 2 million girls across Asia and Africa are estimated to be affected by... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Each year, between 50,000 and 100,000 women worldwide develop obstetric fistulae. Approximately 2 million girls across Asia and Africa are estimated to be affected by this condition. However, there is no reliable data on its prevalence in South-East Asia region (SEAR).
OBJECTIVES
The objective of this study is to systematically review and synthesize the data on the prevalence and management of obstetric fistula in SEAR.
METHODS
We searched for the literature that described the prevalence and management practices of obstetric fistula in SEAR. We followed the PRISMA guidelines to select the articles for the review. The quality and relevance were assessed by two reviewers independently using the SIGN checklist. A total of five articles and reports were selected for the review. To review the management practices, we found 63 original studies that were included in the review.
RESULTS
We found five community-based studies estimating the prevalence of obstetric fistula in SEAR; 3 studies were from India, one from Bangladesh and one from Nepal. The pooled prevalence according to self-reports was 1.11 (3 studies including 671,133 participants, 95% confidence interval [CI] 1.09, 1.14) per 100 women. The pooled prevalence of obstetric fistula based on the clinical examination was 0.10 (3 studies involving 4547 participants, 95% CI 0.01, 0.20) per 100 women. The value was close to the pooled estimate based on the smaller studies.
CONCLUSION
More studies are needed to estimate reliable community-based prevalence data and also need to develop evidence-based management guidelines.
Topics: Asia, Southeastern; Bangladesh; Female; Humans; India; Pregnancy; Prevalence; Vesicovaginal Fistula
PubMed: 33318390
DOI: 10.4103/ijph.IJPH_200_20 -
The American Journal of Case Reports Oct 2023BACKGROUND Emphysematous cystitis is a rare urologic condition typically characterized by abdominal pain, hematuria, and dysuria. In some cases, complications such as...
BACKGROUND Emphysematous cystitis is a rare urologic condition typically characterized by abdominal pain, hematuria, and dysuria. In some cases, complications such as bladder rupture, necrosis, and septic shock have been reported. Emphysematous cystitis has been associated with several predisposing medical conditions, such as diabetes mellitus, recurrent urinary tract infections, and immunosuppression, but can also infrequently present in an undifferentiated fashion without these aforementioned risk factors, such as in our patient's case. CASE REPORT We describe a rare case of emphysematous cystitis in a 67-year-old woman presenting to the Emergency Department with hematuria. The patient's presenting symptoms also included severe lower abdominal pain and dysuria. Examination revealed suprapubic tenderness and gross hematuria. Imaging revealed gas within the bladder lumen and throughout the bladder wall. Radiography showed concerns for emphysematous cystitis, without evidence of bladder fistula formation with adjacent bowel loops or cysto-vaginal fistula. After consultation with the Urology Department, the patient was admitted for serial examinations, intravenous antibiotics, and continued monitoring. The patient was discharged in good condition after a 3-day hospitalization. CONCLUSIONS Clinicians evaluating patients for acute urologic symptoms should be alert to the possible diagnosis of emphysematous cystitis, given the potential for deterioration and concomitant complications. Although our patient's presentation included no traditional risk factors for emphysematous cholecystitis, she required hospitalization to ensure progressive improvement. Therefore, prompt management along with appropriate consultation with specialists are crucial to mitigate the risk of adverse outcomes in this rare urologic emergency.
Topics: Female; Humans; Aged; Urology; Hematuria; Dysuria; Emphysema; Cystitis; Abdominal Pain
PubMed: 37904334
DOI: 10.12659/AJCR.941599 -
International Journal of Surgery Case... 2020The presentation of bladder stones is the most common manifestation of a lower urinary tract stone. In severe cases, it can cause pressure necrosis and lead to...
INTRODUCTION
The presentation of bladder stones is the most common manifestation of a lower urinary tract stone. In severe cases, it can cause pressure necrosis and lead to vesico-vaginal fistula (VVF). This case reports a female patient diagnosed with a bladder stone accompanied by VVF.
PRESENTATION OF CASE
A 56-year-old female came to the hospital with complaints of dysuria accompanied by continual urinary incontinence symptoms dating back about a month. During vaginal examination, we found a fistula and a stone. An ultrasound (US) showed a hyperechoic shadow measuring 1.27 × 1.36 cm in the vesica urinary and plain kidney, ureter, and bladder (KUB) x-ray showed the presence of a radiopaque shadow of about 7.5 × 5 cm in the pelvic area. This stone was removed through an open cystolithotomy. Intraoperatively, a fistula of about 1 cm in diameter was found in the trigonum close to the internal meatus. A fistula repair was performed immediately without complications, and the follow-up results were satisfactory.
CONCLUSION
The presentation of a bladder stone is an uncommon condition that can cause VVF. Therefore, it is important to pay attention to its clinical signs.
PubMed: 32950941
DOI: 10.1016/j.ijscr.2020.09.028 -
Einstein (Sao Paulo, Brazil) 2013Vesicovaginal fistula is an abnormal communication between the bladder and vagina and represents the most frequent type of fistula in the urinary tract. The most common...
Vesicovaginal fistula is an abnormal communication between the bladder and vagina and represents the most frequent type of fistula in the urinary tract. The most common cause in Brazil is iatrogenic fistula, secondary to histerectomia. Classically these women present continuous urinary leakage from the vagina and absence of micturition, with strong negative impact on their quality of life. We present a case of totally continent vesicovaginal fistula, with a follow-up of 11 years with no complications.
Topics: Female; Humans; Hysterectomy; Middle Aged; Reoperation; Urination; Vesicovaginal Fistula
PubMed: 23579756
DOI: 10.1590/s1679-45082013000100022 -
Urology Case Reports Sep 2023Fungus formation in the urinary tract mainly occurs in immunosuppressed patients, and is a rare and dangerous complication of candiduria that is commonly misdiagnosed....
Fungus formation in the urinary tract mainly occurs in immunosuppressed patients, and is a rare and dangerous complication of candiduria that is commonly misdiagnosed. We report a case of intravesical mycetoma associated with hydronephrosis, initially diagnosed as enterovesical fistula. Cystoscopy revealed spongy material within the urinary bladder, and histopathological examination showed Mycetoma of Candida species. The urine culture showed . Endoscopic removal and antifungal therapy with fluconazole was initiated, and no complications occurred during follow-up.
PubMed: 37601833
DOI: 10.1016/j.eucr.2023.102517 -
European Urology Focus Sep 2020Coronavirus disease 19 (COVID-19) has changed standard urology practice around the world. The situation is affecting not only uro-oncological patients but also patients... (Review)
Review
CONTEXT
Coronavirus disease 19 (COVID-19) has changed standard urology practice around the world. The situation is affecting not only uro-oncological patients but also patients with benign and disabling conditions who are suffering delays in medical attention that impact their quality of life.
OBJECTIVE
To propose, based on expert advice and current evidence where available, a strategy to reorganize female and functional urological (FFU) activity (diagnosis and treatment).
EVIDENCE ACQUISITION
The present document is based on a narrative review of the limited data available in the urological literature on SARS-Cov-2 and the experience of FFU experts from several countries around the world.
EVIDENCE SYNTHESIS
In all the treatment schemes proposed in the literature on the COVID-19 pandemic, FFU surgery is not adequately covered and usually grouped into the category that is not urgent or can be delayed, but in a sustained pandemic scenario there are cases that cannot be delayed that should be considered for surgery as a priority. The aim of this document is to provide a detailed management plan for noninvasive and invasive FFU consultations, investigations, and operations. A classification of FFU surgical activity by indication and urgency is proposed, as well as recommendations adopted from the literature for good surgical practice and by surgical approach in FFU in the COVID-19 era.
CONCLUSIONS
Functional, benign, and pelvic floor conditions have often been considered suitable for delay in challenging times. The long-term implications of this reduction in functional urology clinical activity are currently unknown. This document will help functional urology departments to reorganize their activity to best serve their patients.
PATIENT SUMMARY
Many patients will suffer delays in urology treatment because of COVID-19, with consequent impairment of their physical and psychological health and deterioration of their quality of life. Efforts should be made to minimize the burden for this patient group, without endangering patients and health care workers.
Topics: Ambulatory Care; Betacoronavirus; COVID-19; Coronavirus Infections; Cystitis, Interstitial; Disease Management; Female; Humans; Lower Urinary Tract Symptoms; Male; Pandemics; Personal Protective Equipment; Pneumonia, Viral; SARS-CoV-2; Telemedicine; Urinary Incontinence; Urinary Retention; Urinary Tract Infections; Urologic Diseases; Urologic Surgical Procedures; Urology; Vesicovaginal Fistula
PubMed: 32540267
DOI: 10.1016/j.euf.2020.05.023