Successful Case of Conservative Treatment of Vesicovaginal Fistula by Hodge Pessary Insertion

Park, Soo-Hwan; Park, ﻿Won Hee; Kim, Hyeong Gon

doi:10.1111/luts.12061

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…A typical robotic surgery for VVF repair includes the steps contextualized below. The preoperative preparation and plan is necessary for the thorough evaluation of patient's condition and includes various diagnostic tests [3,5].…”

Section: Methodsmentioning

confidence: 99%

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Vesicovaginal Fistulas (VVF): New Dilemmas and Prospectives Review of the Literature

Chrisostomos

2023

J Obst Gynecol Surg

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Although they were first described in 2050 BC in Egypt, Vesicovaginal Fistulas (VVF) still remain a challenging entity for both patients and healthcare services. They often result in the continuous, involuntary leakage of urine into the vaginal canal, leading to significant physical discomfort, psychological distress, and social isolation for the affected individuals. Etiology of VVF remains miscellaneous, with the most common etiology being based on obstetric complications during prolonged labor, particularly in developing and low-resource settings. Other causes include pelvic surgery, radiation therapy, trauma, congenital and underlying medical conditions. Effective diagnosis of VVF relies on the combination of clinical assessment, medical history, physical examination, and diagnostic procedures such as cystoscopy, imaging techniques, and dye tests. Proper detection consists crucial concerning successful treatment and can significantly improve the patient's quality of life. Therapeutic mapping approaches for VVF include both surgical and non-surgical interventions. Conservative management may include catheterization, proper nutrition, and the use of vaginal pessaries. However, surgical intervention remains primary treatment option for most cases, aiming the repair of the fistula and restore normal urinary and reproductive function. Surgical techniques range from simple suturing to complex reconstructive procedures, and the choice of approach depends on the size, location, and complexity of the fistula. While surgical repair offers high success rates, comprehensive postoperative care is vital to ensure optimal outcomes. Additionally, supportive care, including counseling, social reintegration, and rehabilitation, plays a crucial role in the overall recovery process. Aim of our study consists assiduous understanding and knowledge of vesicovaginal fistula. The awareness and attention of the scientific society and healthcare providers need to be aroused regarding new prospectives, strategies and methods of detection and management of VVF.

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Section: Methodsmentioning

confidence: 99%

“…Moreover, only one of the selected studies used the conservative approach. This VVF repair technique was used for the treatment of a simple fistula, 1 cm diameter size [5].…”

Section: Methodsmentioning

confidence: 99%

Vesicovaginal Fistulas (VVF): New Dilemmas and Prospectives Review of the Literature

Chrisostomos

2023

J Obst Gynecol Surg

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“…There was a case reported from Korea after a wait of 3-6 months following an injury with the application of topical estrogen and an indwelling catheter. They reported the first successful case of conservative treatment without surgical repair [53].…”

Section: Conservative Managementmentioning

confidence: 99%

Vesicovaginal Fistulas: Prevalence, Impact, and Management Challenges

Chinthakanan,

Sirisreetreerux,

Saraluck

2023

Medicina

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Background and Objectives: Vesicovaginal fistulas (VVFs) are an abnormal communication between the vagina and bladder and the most common type of acquired genital fistulas. This review will address the prevalence, impact, and management challenges of VVFs. Materials and Methods: Epidemiologic studies examining VVFs are considered. In addition, publications addressing the treatment of VVFs are reviewed. Results: VVFs in developing countries are often caused by obstructed labor, while most VVFs in developed countries have iatrogenic causes, such as hysterectomy, radiation therapy, and infection. The reported prevalence of VVFs is approximately 1 in 1000 post-hysterectomy patients and 1 in 1000 deliveries. VVFs affect every aspect of quality of life, including physical, mental, social, and sexual aspects. Prevention of VVFs is essential. Early diagnosis is necessary to reduce morbidity. Nutrition, infection control, and malignancy detection are important considerations during evaluation and treatment. Conservative and surgical treatment options are available; however, these approaches should be customized to the individual patient. The success rate of combined conservative and surgical treatments exceeds 90%. Conclusions: VVFs are considered debilitating and devastating. However, they are preventable and treatable; key factors include the avoidance of prolonged labor, careful performance of gynecologic surgery, and early detection.

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Vesico-vaginal fistula presenting as overactive bladder in a case of Gellhorn pessary for vault prolapse

Bhat

Agur

2021

BMJ Case Rep

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An 81-year-old woman with early dementia was on a regular follow-up for change of Gellhorn pessary every 6 months for vault prolapse. She presented with frequency and urgency for 10 months duration 5 years into conservative management. Her symptoms did not improve on anticholinergics and lifestyle modifications. She underwent an opportunistic change of pessary under general anaesthesia coincidental to scalp wound debridement. On removal of the pessary, a gush of urine was noted followed by confirmation of a large vesico-vaginal fistula (VVF). In the initial period of follow-up, she was reviewed by the urogynaecology team and considered to be a poor surgical candidate for a major surgical procedure and was offered conservative measures with incontinence pads and possible indwelling catheter. Serious complications like fistulae can still occur despite well-managed pessary treatment. Earlier presentation with overactive bladder symptoms masked the VVF resulting in delayed diagnosis.

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Successful Case of Conservative Treatment of Vesicovaginal Fistula by Hodge Pessary Insertion

Abstract: The conservative approach could be an option of treatments of vesicovaginal fistula caused by neglected vaginal pessary.

Cited by 3 publications

References 18 publications

Vesicovaginal Fistulas (VVF): New Dilemmas and Prospectives Review of the Literature

Vesicovaginal Fistulas (VVF): New Dilemmas and Prospectives Review of the Literature

Vesicovaginal Fistulas: Prevalence, Impact, and Management Challenges

Vesico-vaginal fistula presenting as overactive bladder in a case of Gellhorn pessary for vault prolapse

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