Vesicovaginal Fistula
| A | Suprapubic needle aspiration | |
| B |
Midstream clean catch |
|
| C |
Foley’s catheter |
|
| D |
Sterile speculum |
The most appropriate method for collecting urine for culture in case of vesicovaginal fistula is :
| A |
Suprapubic needle aspiration |
|
| B |
Midstream clean catch |
|
| C |
Foley’s catheter |
|
| D |
Sterile speculum |
Foley’s catheter
Vesicovaginal fistula repair surgery, the drainage should be done for :
| A |
6 days |
|
| B |
10 days |
|
| C |
12 days |
|
| D |
14 days |
14 days
Vesicovaginal fistula by obstructed labour manifests………………of delivery :
| A |
Within 24 hours |
|
| B |
Within 72 hours |
|
| C |
Within 1st week |
|
| D |
After 1st week |
After 1st week
Which of the following is the most appropriate method for collecting urine for culture in the case of vesicovaginal fistula?
| A |
Sterile speculum |
|
| B |
Foley’s catheter |
|
| C |
Midstream clean catch |
|
| D |
Suprapubic needle aspiration |
Ans. is B. i.e. Foley’s catheter
- Ureteric catheterization is the best method of collecting urine for culture in the case of vesicovaginal fistula.
- The second best method of collection of urine is a suprapubic aspiration, which needs a full bladder and is not possible in this case.
- The collection of urine via sterile speculum and midstream clean-catch leads to contamination of urine.
- So by exclusion, the best answer is the collection of urine using a foley’s catheter.
| A |
Triple Swab Test |
|
| B |
Urine culture |
|
| C |
Cystoscopy |
|
| D |
IVP |
A 52 year old lady with a vesicovaginal fistula after abdominal hysterectomy is not responding to conservative management. Most useful and important next investigation is:
| A |
Triple Swab Test |
|
| B |
Urine culture |
|
| C |
Cystoscopy |
|
| D |
IVP |
Which is the MOST common cause of vesicovaginal fistula in India?
| A |
Gynae Surgery |
|
| B |
Irradiation |
|
| C |
Obstructed labour |
|
| D |
Trauma |
- Rupture of uterus
- Cesarean section
- Kielland forceps can injure the bladder during rotational delivery
- Abdominal hysterectomy for PID, endometriosis and cervical fibroid
- Radiotherapy cause bladder fistula few months to 2 years due to ischemic vascular necrosis
- TB, cancer of lower genital tract, and rarely a bladder stone and perforated IUCD
What is the time duration for developing a vesicovaginal fistula following an obstructed labour?
| A |
Within 24 hours |
|
| B |
WiiW 72 hours |
|
| C |
Within 1st week |
|
| D |
After 1st week |
With dystocia, the presenting part is firmly wedged into the pelvic inlet and does not advance for a considerable time.
Tissues of the birth canal lying between the leading part and the pelvic wall may be subjected to excessive pressure.
Because of impaired circulation, necrosis may result and become evident several days after delivery as vesicovaginal, vesicocervical, or rectovaginal fistulas.
In vesicovaginal fistula, dribbling of urine occurs after varying interval following delivery (5-7 days). Most often, pressure necrosis follows a very prolonged second stage.
| A |
Within 24 hours |
|
| B |
Within 72 hours |
|
| C |
Within 1st week |
|
| D |
After 1st week |
- The vesicovaginal fistula may present days to weeks after the initial inciting surgery, and those following hysterectomy typically present at 1 to 3 weeks.
- It classically presents with unexplained continuous urinary leakage from the vagina after a recent operation.
- Other less specific symptoms of genitourinary fistula include fever, pain, ileus, and bladder irritability.
Most common genital fistula in India is:
September 2011, March 2013
| A |
Ureterovaginal fistula |
|
| B |
Ureteroabdominal fistula |
|
| C |
Urethrovaginal fistula |
|
| D |
Vesicovaginal fistula |
Ans. D: Vesicovaginal Fistula
| A |
Vesicovaginal fistula. |
|
| B |
Vesicouterine fistula. |
|
| C |
Urethrovaginal fistula. |
|
| D |
None of the above. |
The type of fistula ‘2’ shown in the photograph above represents Vesicovaginal fistula.
Vesicovaginal fistula (VVF) is a subtype of female urogenital fistula (UGF). VVF is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault
