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One of the rare birth defects in women is vaginal fistula, it has caused many troubles and directly affects the daily life and health of the patient.
1. Vaginal fistula
Vaginal fistula is an abnormal hole in the vagina that is connected to another organ such as the bladder, ureter, urethra, rectum, colon, .. Which manifests as a condition of urinary products. Secretions of other organs will follow the fistula to flow into the vagina, thereby causing different clinical symptoms. The amount of stool or urine that enters the vagina depends on the size and location of the fistula.
Causes of vaginal fistula can be due to surgery in the vicinity, complications during childbirth, trauma after an accident, cancer or radiation therapy for cancer or infection can all cause these problems. vaginal fistula.
There are vaginal fistulas such as:
Vaginal - bladder fistula: Also known as bladder fistula is the most common type of fistula, usually appearing after 7-14 days after surgery, urine will flow out into the vagina through the fistula. To determine this condition, people use blue methylene solution pumped into the urethra through a catheter and use tampons inserted into the vagina, after the bladder is filled with water, the tampon has a stain. Vaginal - ureteral fistula: The ureter is the tube that carries urine from the kidney to the bladder, the positions of the ureter are at risk of creating fistulas with the vagina. This is called a ureteral fistula.
Lỗ rò âm đạo - bàng quang là loại xuất hiện thường xuyên nhất
Vaginal - urethral fistula: The ureter is the tube that carries urine from the bladder out of the body, where the contact between the urethra and the vagina can create a fistula, also known as a urethral fistula. Vaginal-rectum fistula: The rectum is the last part of the large intestine, which connects to the anus, this fistula can cause stools from the rectum to flow through the vagina. Vaginal-colon fistula Vaginal-intestinal fistula To solve this fistula, doctors will have to close the vaginal fistula with surgery or electrocautery depending on the size and location of the fistula. . Closing the fistula prevents stool and urine from entering the vagina, which can cause infection and pain. One of the surgeries of interest today is the surgery to close the vaginal - urethral fistula, also known as the urethral fistula.
2. How to close the urethral fistula?
A urethral fistula is an abnormal opening from the urethra into the vagina. To handle, the doctor will apply the method of fistula electrocautery, injection, bio-glue application, combined with bladder drainage to help the fistula become scarified, and surgical.
2.1. Indications
Congenital urethral-vaginal fistula Congenital urethral-vaginal fistula due to acquired causes 2.2. Contraindications:
When you have a urinary tract infection
Đóng lỗ rò niệu đạo chống chỉ định khi bệnh nhân bị viêm đường tiết niệu
2.3. Preparing for surgery
Explain to the patient and family about health-related problems as well as the surgery before the operation Improve physical condition Stable treatment of medical diseases Fasting, enema , cleaning the surgical area Using prophylactic antibiotics Preparing for major surgery 2.4. Carrying out surgery
Put the person in the obstetric position Disinfect the abdomen below the navel, vagina and perineum Expose the vagina and vaginal fistula - urethra Stitch the baby's lips to the skin, insert a urethral catheter , put valve in posterior vaginal wall Fistula analysis Inject lidocaine solution + 0.9% saline serum + adrenaline 1:200,000 into the submucosal layer of the vaginal wall Incision around the circumference of the fistula in the vaginal wall, separate vaginal wall from the fistula and the urethral wall Fistula resection closes the fistula in the urethral wall with a slow indicator Close the vaginal wall Place a betadine-impregnated vaginal meche After surgery to monitor and handle possible complications such as infection, dysuria, urinary retention and instruct the patient on hygiene and postoperative care.
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