Genitourinary fistula
by Saxena Richa

Tips & Tricks in Operative Obstetrics & Gynecology

by Richa Saxena
About Video

This video shows a case study of a woman with complain of leakage of urine since 4–5 years. Obstetric and past history of that woman are provided along with different clinical examinations such as general physical examination, per abdominal examination, per speculum examination and per vaginal examination. Urine investigations, renal functional tests, methylene blue three-swab test, ultrasonography, etc. are carried out for the investigation. Cystoscopy is indicated in case of multiple fistulae to determine their location and relation to the trigone and ureteric orifices. A methylene blue dye test is required to confirm the diagnosis and help the surgeon plan the repair process. Different types of genitourinary fistula are shown in this video with the help of well-illustrated figure. Conservative treatment is considered for small fistula (< 1 cm). The vaginal approach for surgery includes Latzko partial colpocleisis procedure and Chassar Moir Flap-splitting technique which are explained in this video. Urinary diversion procedure can be considered in the cases where there is extensive loss of bladder tissue, previous failed attempts at fistula closure or fistula formation due to radiation injury.

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