Fistula Flashcards
What Type of hysterectomy is most associated with vesicovaginal fistulas?
Total Laparoscopic hysterectomy
What hysterectomy has the lowest rate of fistula?
Vaginal hysterectomy
What is the initial study of choice to diagnose a vesicovaginal fistula?
retrograde fill with methylene blue, tampon test.
What is the study of choice to diagnose a urethovaginal fistula?
Cystourethroscopy
What is the study of choice for a ureterovaginal fistula?
CT IV Pyelogram
What is the rate of urovaginal fistula following Surgery?
1%
What is the overall rate of GU injury at the time of gynecologic surgery?
0.3 - 4.3%
What surgery carries the highest rate of bladder injury
TVH and LAVH
What surgery carries the highest risk of ureteral injury?
radical abdominal hysterectomy
What is the first line treatment option for small fistulas discovered soon after surgery?
prolonged bladder drainage with foley
In what scenario is prolonged bladder drainage for fistula not a treatment option?
In cases of fistula secondary to malignancy or radiation
What suture type and stitch type is used to repair fistulas?
Interrupted stitches of Vicryl 2-0, 3-0
What is the rate of surgical cure of post hysterectomy fistula?
> 85%
What is the rate of surgical cure rate of obstetric fistula?
80 - 90%
What is the rate of surgical cure rate following radiation, malignancy or trauma related fistula?
50 - 90%
