Vesical Calculi Associated with Vesicovaginal Fistulas: Management Considerations

Abstract

No AccessJournal of Urology1 Jul 1986Vesical Calculi Associated with Vesicovaginal Fistulas: Management Considerations T.P. Mahapatra, M.S. Rao, K. Rao, S.K. Sharma, and S. Vaidyanathan T.P. MahapatraT.P. Mahapatra More articles by this author , M.S. RaoM.S. Rao More articles by this author , K. RaoK. Rao More articles by this author , S.K. SharmaS.K. Sharma More articles by this author , and S. VaidyanathanS. Vaidyanathan More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)44742-2AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Vesical calculi were detected in 5 patients with a vesicovaginal fistula. Of these patients 3 had undergone unsuccessful repair of the fistula previously. The predisposing factors for vesical calculous formation in patients With a vesicovaginal fistula in whom urine leaks continuously into the vagina and urinary stasis does not occur in the bladder, as in patients with neurogenic bladder dysfunction or bladder outlet obstruction, are a foreign body (for example nonabsorbable suture material used during previous surgery), incrustation around an indwelling catheter and infection. The vesical calculus is removed transvaginally after enlarging the fistula by a vertical incision at the 6 o’clock position. The incised edges do not usually bleed because of fibrosis and scar formation, and they need not be approximated at that operation. Indwelling catheter drainage is not necessary after transvaginal cystolithotomy in this situation. This operation is preferable to suprapubic cystolithotomy, which may lead to more morbidity from urine leakage in the retropubic space and subsequent fibrosis, in addition to producing bladder scarring, hindering any future reconstructive surgery requiring the use of vesical flaps. Transvaginal cystolithotomy is contraindicated when the fistula is situated close to the bladder neck (for fear of damaging the bladder neck and the vesical continence mechanism) or when the stone is large. Repair of the fistula is undertaken after an interval of 3 months to allow for resolution of stone-induced edema and friability of the vesical wall © 1986 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byDALELA D, GOEL A, SHAKHWAR S and SINGH K (2018) Vesical Calculi With Unrepaired Vesicovaginal Fistula: A Clinical Appraisal of an Uncommon AssociationJournal of Urology, VOL. 170, NO. 6, (2206-2208), Online publication date: 1-Dec-2003. Volume 136Issue 1 Part 1July 1986Page: 94-95 Advertisement Copyright & Permissions© 1986 by The American Urological Association Education and Research, Inc.MetricsAuthor Information T.P. Mahapatra More articles by this author M.S. Rao More articles by this author K. Rao More articles by this author S.K. Sharma More articles by this author S. Vaidyanathan More articles by this author Expand All Advertisement PDF downloadLoading ...