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Chapter-24 Urinary Leak

BOOK TITLE: Textbook on Complications in Gynecological Surgery

Author
1. Natarajan Suma
2. Ramalingam
3. Sindhu AR
4. Anandi S
ISBN
9788180617140
DOI
10.5005/jp/books/10963_24
Edition
1/e
Publishing Year
2006
Pages
6
Author Affiliations
1. GKNM Hospital, Coimbatore, Ganga Women and Child Centre, Coimbatore, Tamil Nadu, India
2. GKNM Hospital, Gujarat
3. GKNM Hospital, Gujarat
4. GKNM Hospital, Gujarat
Chapter keywords
Urinary leak, Ureter, Hydronephrosis cystoscopy fistula, Vesicovaginal fistula, Ureterovaginal fistula, Indigocarmine, Retrograde ureterogram, Urethral injury, Percutaneous nephrostomy, Ureteroureterostomy, Ureterocolostomy, VVF

Abstract

The chapter begins with 2 case histories of ureteric injuries treated, one with a stent, and another with a rare transvesical approach to fistula repair. Potential risk factors for fistula formation are enumerated. Key steps for evaluation like, examination of vaginal capacity, Psoas spasm, indigocarmine test, double dye test, etc. are enumerated beside routine tests like checking of renal parameters, cystoscopy, intravenous urogram, etc. Algorithms describing pathophysiology of urinary leak and evaluation of urinary like are given. Treatment of ureteric leak, depending on the site of leak is described. Timing of vesical injuries are discussed and an overview of vesicovaginal fistula given.

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