Case
Vesicouterine fistula (VUF) is the rarest form of genitourinary fistulas. As lower‐segment cesarean section becomes a more common mode of delivery, they have become the leading cause of VUF formation. We present four VUF patients with varied symptoms such as menouria, amenorrhea, with or without urinary incontinence. We diagnosed all of our cases through cystoscopy in conjunction with methylene blue dye test or hysteroscopy.
Outcome
We successfully repaired VUF in three open surgery instances and one laparoscopic case. To diagnose VUF, cystoscopy and hysteroscopy are still the gold standard. An expert surgeon's open or laparoscopic repair is effective and safe. The patients no longer experienced incontinence, cyclical hematuria (menouria), discomfort, or sexual dysfunction.
Conclusion
Cystoscopy and hysteroscopy remain the gold standard tool in diagnosing VUF. Open or laparoscopic repair performed by an experienced surgeon is an effective and safe technique with a successful outcome.
Objective: The purpose of this study is to examine the difference of lower urinary tract (LUT) symptoms in anuric and non-anuric individuals after renal transplantation (RT). Material & Methods: LUT function and symptoms were assessed in subjects who had undergone RT at Cipto Mangunkusumo General Hospital, Jakarta, from November 2016 to June 2017. Subjects were divided into anuric and non-anuric groups. We excluded patients with surgical complications that could not undergo uroflowmetry. Results: Thirty-two (21 male, 11 female) subjects were recruited in this study. The anuric subjects were younger than the non-anuric ones (47 ± 12.82 vs. 51.31 ± 16.33, p < 0.001) There were no significant differences in the International Prostate Symptoms Score (IPSS) (6.5 ± 3.67 vs. 6.25 ± 2.95, p = 0.567), Overactive Bladder Symptoms Score (OABSS) (4.06 ± 2.01 vs 4.12 ± 2.39, p = 1.000), maximum urinary flow rate (Qmax) (20.32 ± 9.04 vs. 22.32 ± 10.31, p = 0.956), post-void residual (PVR) (41.12 ± 37.63 vs. 47.62 ± 38.63, p = 0.361) and voided volume (227.88 ± 112.30 vs 251.06 ± 126.75, p = 0.588) between anuric and non-anuric subjects, respectively. IPSS-voiding symptom, IPSS-storage symptom, and OAB symptom did not differ significantly between both groups (p > 0.05). Thirteen (13/16) and seven (7/16) subjects of the anuric and non-anuric groups were both pleased with their quality of life, respectively. Conclusion: LUT symptoms do not differ between anuric and non-anuric patients.
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