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Urology (Expert Forum)
Re: fistula
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Re: fistula
by Emily__0__0, Jan 01, 1995 12:00AM
Posted By Emily on July 19, 1999 at 01:13:32
Dear Doctor,
I had a hysterctomy and bladder sling installed in July of 1997. Before the surgery I had some leaking when sneezing. After the surgery, I had a catheter for over a month, because I could not empty my bladder correctly. I also started having constant urinary infections, and a discharge from my vagina. After about three months, I started to bleed, but the urologist and gynecologist could not determine if I was bleeding from the vagina or urethra. The urologist put me on different antibiotics, but the infections continued. The gynecologist noticed a lesion in my vagina and referred me back to the urologist. The urologist said I had a growth in my vagina that needed to be removed and I had surgery in April of 1999. The bleeding continued, and the urologist referred me back to the gynecolost. By this time I felt really frustrated, so I went to my primary doctor for advice on what to do. She examined me and said I had a fistula that was leaking urine from my urethra to my vagina and she referred me to a different urologist. This urologist examened me and recommended that I have the sling removed, but he said that he didn't thing I had a fistula. I had surgery on July 2nd. The doctor said I indeed had a fistula and he repaired it as best as he could, but that there were no guarantees that the fistula would heal. I have not bled since, and the pain that I was experiencing with the sling is gone, so I am very much relieved. I still have a catheter on, but I am scheduled to have it removed this week. My question is, where do I go from here? I continue to leak more than ever now? Will I need further surgery to correct this? And what hope to give me for the fistula? I am 52 years old.
Thank you for any advice you can give me. Emily
Dear Doctor,
I had a hysterctomy and bladder sling installed in July of 1997. Before the surgery I had some leaking when sneezing. After the surgery, I had a catheter for over a month, because I could not empty my bladder correctly. I also started having constant urinary infections, and a discharge from my vagina. After about three months, I started to bleed, but the urologist and gynecologist could not determine if I was bleeding from the vagina or urethra. The urologist put me on different antibiotics, but the infections continued. The gynecologist noticed a lesion in my vagina and referred me back to the urologist. The urologist said I had a growth in my vagina that needed to be removed and I had surgery in April of 1999. The bleeding continued, and the urologist referred me back to the gynecolost. By this time I felt really frustrated, so I went to my primary doctor for advice on what to do. She examined me and said I had a fistula that was leaking urine from my urethra to my vagina and she referred me to a different urologist. This urologist examened me and recommended that I have the sling removed, but he said that he didn't thing I had a fistula. I had surgery on July 2nd. The doctor said I indeed had a fistula and he repaired it as best as he could, but that there were no guarantees that the fistula would heal. I have not bled since, and the pain that I was experiencing with the sling is gone, so I am very much relieved. I still have a catheter on, but I am scheduled to have it removed this week. My question is, where do I go from here? I continue to leak more than ever now? Will I need further surgery to correct this? And what hope to give me for the fistula? I am 52 years old.
Thank you for any advice you can give me. Emily
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Dear Shelly,
Thank you for your inquiry. Women with stress urinary incontinence often are treated surgically with a pubovaginal sling. The sling has been used with good success. Different materials have been implanted to create a sling some being autologous tissue and some artificial. The most recent materiel being the protogen sling. The artificial slings have been shown to have a higher rate of erosion through. the anterior vaginal wall. The presenting sign being discharge from the vagina. The sling is explanted once it has eroded. One of the main complication from slings is urinary retention and opposite side of the spectrum continued stress incontinence.
The continued bleeding you have experienced is difficult to comment upon but it sound like the sling eroded through the vagina causing some bleeding and urinary incontinence. The fistula you have refer to can be a difficult complication to treat. The cause of a fistula tract include foreign body i.e.sling, cancer, obstruction, infection. It is important to allow the fistulous tract to heal with catheter drainage and it may take several weeks to months.. If you continue to have leakage soon after the procedure it will not likely improve. The majority of urologist are waiting for about six months before trying a second sling/bladder neck suspension. Autologous rectus fascia appears to have lower erosion rates.
Sincerely,
HFHS M.D.-JS
*Keyword:Fistula
Follow Ups:
fistula Emily 8/10/1999
(2)
Re: fistula HFHS M.D.-AK 8/24/1999
(1)
fistula Emily 9/16/1999
(0)