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vasicovaginal fistula
Discussion in 'All Categories' started by Amita Das - Aug 11th, 2013 5:02 pm.
Amita Das
Amita Das
In november last year TLH was done on me. For a month everything was fine, however, a foul smelling discharge through vagina started mid of jan. I was initially told that my internal stitches were taking time to heal and given a lot of antibiotics. The problem kept getting severe and I suffered from severe pain. The cat scan and MRI done in mid of Feb showed a large abscess It was subsequently drained on end of feb (it contained thick mass) , no malignancy was reported though in biopsy. I was relived of pain but the discharge through vagina continued. I was kept on antibiotics. Daily cleaning was also carried out but that did not heal it. I was then referred to other doctors, an EUA done on April end this year confirmed that I had vasico vaginal fistula. The tissues being necrotic I was kept on catheter. I could tolerate the catheter only for about six weeks, blood in urine started coming, I suffered from excessive pain and had infection. The catheter was removed did a course on anti biotics and the pain has subsided. However I have lost the sensation of urine and have to wear diapers. I feel (am not sure ) that the vaginal discharge is almost gone. After the pain subsided I got the cat scan done again. It shows clearly that I have a vasico vaginal fistula of 2.5 mm size. The abscess size seems to have reduced but it is pressurizing my ureter and the kidneys are showing signs of hydronephrosis. The cat scan (all the three feb, April and August 9) also show a lesion in the wall of the bladder. The size seems to have reduced in the last scan.

I am a single women 48 years of age, so the access through vagina has a very limited space. The doctors are therefore now reluctant to repair the fistula. What is your suggestion to this. Should I live with the discomfort whole of my life or do I have to go for a surgery and what kind of surgery. I have gone through so much pain and am very scared of surgery related complications now. A simple TLH has landed me in so much trouble that I do not have the courage of taking any chances any more. What is your suggestion ?
re: vasicovaginal fistula by Dr J S Chowhan - Aug 18th, 2013 9:38 pm
Dr J S Chowhan
Dr J S Chowhan
Dear Anita Das

Most of the vesicovaginal fistula should heal itself and as your abscess size is reducing we hope that it should heal slowly. However, you have written that it is pressurizing your ureter and the kidneys are showing signs of hydronephrosis. This is not good and you should get one IVP done. If lesion of wall of bladder is pressurizing the ureter then you may need surgery. To give you complete and proper advice you should contact any good urologist. 2.5 mm fistula can heal slowly most of the time but hydonephrosis is not good. Only thing you should do at this time is that please remain in contact with a urologist and follow his advice.

With regard

J S Chowhan
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