Early detection and endoscopic management of post cesarean section ureterovaginal fistula : a case series study
© 2020. The International Urogynecological Association..
INTRODUCTION AND HYPOTHESIS: The aim of this study was to evaluate the endourologic management of post-cesarean section ureterovaginal fistula.
METHODS: Between February 2016 and March 2019, eight patients presented because of vaginal leakage after cesarean section. All presented within 15 days from their original operations. Three of the patients had a vague lower abdominal pain, and five had ipsilateral flank pain; all had vaginal leakage. Physical examination, ultrasonography, and IVP were done to confirm the diagnosis. Ureteroscopy was the first treatment attempt, using two or three guide wires to find the proximal part of the ureter and insert a JJ stent.
RESULTS: In six patients, we could insert guide wires, find the proximal part of the ureter, and finally insert a JJ stent. In two patients, we could not even pass a guide wire, so we changed the position, and ureteral reimplantation was done. The stents were removed after 6 weeks, and after 3 months an IVP was planned again that showed all fistulae had resolved with no evidence of ureteral stricture.
CONCLUSION: In cases of ureterovaginal fistula after cesarean section, ultrasonography and IVP with lateral view x-ray films may confirm the diagnosis. The traditional treatment for ureterovaginal fistula is ureteral reimplantation, but endoscopic management may be a viable technique with less invasiveness and faster results and recovery. Thus, retrograde stenting can be accomplished in selected patients with ureterovaginal fistula after cesarean section and may eliminate the need for reimplantation of the ureter.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:32 |
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| Enthalten in: |
International urogynecology journal - 32(2021), 9 vom: 11. Sept., Seite 2537-2541 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Rabani, Seyed Mohammadreza [VerfasserIn] |
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| Links: |
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| Themen: |
Cesarean section |
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| Anmerkungen: |
Date Completed 20.09.2021 Date Revised 20.09.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00192-020-04589-7 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM317428497 |
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| 100 | 1 | |a Rabani, Seyed Mohammadreza |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Early detection and endoscopic management of post cesarean section ureterovaginal fistula |b a case series study |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 20.09.2021 | ||
| 500 | |a Date Revised 20.09.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020. The International Urogynecological Association. | ||
| 520 | |a INTRODUCTION AND HYPOTHESIS: The aim of this study was to evaluate the endourologic management of post-cesarean section ureterovaginal fistula | ||
| 520 | |a METHODS: Between February 2016 and March 2019, eight patients presented because of vaginal leakage after cesarean section. All presented within 15 days from their original operations. Three of the patients had a vague lower abdominal pain, and five had ipsilateral flank pain; all had vaginal leakage. Physical examination, ultrasonography, and IVP were done to confirm the diagnosis. Ureteroscopy was the first treatment attempt, using two or three guide wires to find the proximal part of the ureter and insert a JJ stent | ||
| 520 | |a RESULTS: In six patients, we could insert guide wires, find the proximal part of the ureter, and finally insert a JJ stent. In two patients, we could not even pass a guide wire, so we changed the position, and ureteral reimplantation was done. The stents were removed after 6 weeks, and after 3 months an IVP was planned again that showed all fistulae had resolved with no evidence of ureteral stricture | ||
| 520 | |a CONCLUSION: In cases of ureterovaginal fistula after cesarean section, ultrasonography and IVP with lateral view x-ray films may confirm the diagnosis. The traditional treatment for ureterovaginal fistula is ureteral reimplantation, but endoscopic management may be a viable technique with less invasiveness and faster results and recovery. Thus, retrograde stenting can be accomplished in selected patients with ureterovaginal fistula after cesarean section and may eliminate the need for reimplantation of the ureter | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cesarean section | |
| 650 | 4 | |a Ureteroscoic surgical procedure | |
| 650 | 4 | |a Vaginal fistula | |
| 700 | 1 | |a Rabani, Seyedhossein |e verfasserin |4 aut | |
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