Management Of Urinary Fistulas Research Articles

A simple score for predicting urinary fistula in patients with renal hydatid cysts

ABSTRACT Hydatid cyst is a major health problem in developing countries. The kidney is in third position of organs affected by hydatid cyst. One of the complications of renal hydatid cyst is a urinary fistula. The purpose of this study is to identify preoperative predictive factors of urinary fistula in renal hydatid cyst and to develop a scoring system for this disorder. We retrospectively analyzed all patients operated for renal hydatid cysts between January 2000 and December 2020. We divided our patients into two groups according to whether or not the renal hydatid cysts opened in the urinary tract. Predictive factors of the presence of a urinary fistula have been studied to obtain a simple score to predict the presence of a urinary fistula. Differences were considered significant if p < 0.05. Urinary fistula was detected in 33 of 96 patients. Univariate analyses showed significant differences in patient age, cyst size, location, hydaturia, eosinophil count, and platelet count between patients with and without urinary fistula. In multivariate analyses, hydaturia (p < 0.005), eosinophil count >500/mm3, (p = 0.01), cyst diameter >5 cm (p = 0.02), and upper or lower renal pole location (p = 0.003) were significant and independent predictors of urinary fistula. A score was developed to predict the opening of the cyst in the urinary tract. The total score varies between 0 and 15. The resulting area under the receiver operator characteristic curve was 0.798 (95% CI, 0.726–0.866; p = 0.023). At a cutoff point ≥8, the specificity achieved was 100%. Preoperative detection and management of urinary fistula are important issues in the treatment of renal hydatid cyst. Developing a scoring system based on routinely measured laboratory and radiologic factors will help the clinician to manage patients with renal hydatid cysts. External studies are needed to validate this new scoring system in routine clinical practice.

Urinary fistula-A continuing problem with changing trends.

Objective:Urinary fistula is a distressing complication after difficult vaginal deliveries, obstetric, and gynecologic surgeries. The present study describes a single center’s experience in the management of urinary fistula at a tertiary care hospital. It was performed to analyze the etiology of genitourinary fistula, to assess the outcome after surgical repair, and to determine the changing trends in the etiology and management of urinary fistula.Material and Methods:This retrospective study was conducted over 5 years in the department of obstetrics and gynecology, All India Institute of Medical Sciences, New Delhi. Twenty patients who underwent surgical repair of urinary fistula were included in the study and analyzed for their etiology, presentation, site, size, previous failed repair, approach of surgical repair, and outcome. The findings of the present study were compared with a previous study at our center to determine the changing trends of urinary fistula.Results:The mean age of the study population was 37.05±8.08 years. The majority (65%) of the fistulae occurred following gynecologic surgeries, whereas 25% were due to obstructed labor, and 10% after cesarean section for other indications. The vaginal approach was used in all except one case of uterovesical fistula, which was repaired abdominally. The outcome was successful in 85% of cases. The success rate was similar in primary versus previous failed repair (p=0.270).Conclusion:The most common cause of urinary fistula in the present study was gynecologic surgery. The vaginal approach can be used even in cases with previous failed repairs with a high success rate.

O591 CHANGING AETIOLOGY AND MANAGEMENT OF URINARY FISTULA. AN EXPERIENCE AT TERTIARY CARE HOSPITAL PAKISTAN

International Journal of Gynecology & ObstetricsVolume 119, Issue S3 p. S470-S470 Free communication (oral) presentations O591 CHANGING AETIOLOGY AND MANAGEMENT OF URINARY FISTULA. AN EXPERIENCE AT TERTIARY CARE HOSPITAL PAKISTAN P.S. Sachdev, P.S. SachdevSearch for more papers by this author P.S. Sachdev, P.S. SachdevSearch for more papers by this author First published: 22 October 2012 https://doi.org/10.1016/S0020-7292(12)61021-2AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume119, IssueS3Abstracts of XX FIGO World Congress of Gynecology and ObstetricsOctober 2012Pages S470-S470 RelatedInformation

Lesiones del tracto urinario en cirugía ginecológica

We retrospectively analyzed 27 patients with urinary tract injuries who underwent gynecologic surgery from January 1, 2001 to December 31, 2009. The type and timing of injury, diagnostic methods and management of urinary fistulas were evaluated. Twenty-seven urological injuries were incurred during 6,276 gynecologic surgical procedures, representing an incidence of 0.43%. There were 12 urethral injuries and 15 bladder injuries, with an incidence of 0.19% and 0.24%, respectively. Urinary tract injury was diagnosed intraoperatively in 15 patients (55.5%) and postoperatively in 12 (44.5%). Urinary fistulas occurred in nine patients (33%). Most of the urinary tract injuries occurring in gynecologic surgery had optimal results when diagnosed early and managed correctly.

MP-22.10: Management of urinary fistula: experience in a tertiary care hospital in Dhaka city

MP-22.10: Management of urinary fistula: experience in a tertiary care hospital in Dhaka city

Omental interposition in the management of urinary fistulas involving the vagina

SummaryThis study was undertaken to assess the effect of omental interposition in the management of urinary fistulas involving the vagina. A total of 33 patients were referred to the urology department of the Cardiff Royal Infirmary for closure of vagino-urinary fistulas, over 10 years. There were 20 simple and 13 complex fistulas. A 100 per cent success rate was achieved in terms of fistulas closure using the omental interposition technique irrespective of the aetiology. We recommend that a suprapubic approach and omental interposition should be considered for all urinary fistulas involving the vagina and is the procedure of choice in all complex cases.

The Management of Urinary Fistulas and Strictures with Percutaneous Ureteral Stent Catheters

A method is described for percutaneous anterograde introduction of a ureteral stent catheter. The experience and treatment of 5 patients are reported: 2 ureterovaginal fistulas, 2 ureterocutaneous fistulas and 1 ureteral stricture. The capability of the technique to place a stent catheter in the presence of an almost complete separation of the ureter or through ureteral segments deformed by extensive cicatricial changes is emphasized. The method is advocated as a most effective alternative to supravesical drainage in patients with ureteral fistulas and impaired healing potential of ureters devitalized by surgical stripping and/or radiation therapy.

Management of Urinary Fistulas after Renal Transplantation

Urinary fistulas developed In 13 of 134 patients after renal transplantation. Bladder fistulas originating from the anterior suture line in 6 patients were satisfactorily managed by urethral or paravesical drainage. Fistulas arising from the donor ureter were best treated by surgical repair using the recipient’s own ureter. Caliceal fistulas in 3 patients were successfully treated with nephrostomy drainage. A favorable outcome was achieved in 11 of the 13 patients, with closure of the fistula and preservation of renal function.

Urological Complications in Renal Transplantation

No AccessJournal of Urology1 Nov 1974Urological Complications in Renal Transplantation W.L. Marx, N.A. Halasz, A.P. Mclaughlin, and Ruben F. Gittes W.L. MarxW.L. Marx More articles by this author , N.A. HalaszN.A. Halasz More articles by this author , A.P. MclaughlinA.P. Mclaughlin More articles by this author , and Ruben F. GittesRuben F. Gittes More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)59793-1AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1974 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byShoskes D, Hanbury D, Cranston D and Morris P (2018) Urological Complications in 1,000 Consecutive Renal Transplant RecipientsJournal of Urology, VOL. 153, NO. 1, (18-21), Online publication date: 1-Jan-1995.Thrasher J, Temple D and Spees E (2018) Extra Vesical versus Leadbetter-Politano Ureteroneocystostomy: A Comparison of Urological Complications in 320 Renal TransplantsJournal of Urology, VOL. 144, NO. 5, (1105-1109), Online publication date: 1-Nov-1990.Ohl D, Konnak J, Campbell D, Dafoe D, Merion R and Turcotte J (2018) Extra Vesical Ureteroneocystostomy in Renal TransplantationJournal of Urology, VOL. 139, NO. 3, (499-502), Online publication date: 1-Mar-1988.Hefty T (2018) Experience with Parallel Incision Extravesical Ureteroneocystostomy in Renal TransplantationJournal of Urology, VOL. 134, NO. 3, (455-456), Online publication date: 1-Sep-1985.Novick A (2018) Editorial CommentsJournal of Urology, VOL. 134, NO. 3, (456-456), Online publication date: 1-Sep-1985.Smith R (2018) Editorial CommentsJournal of Urology, VOL. 134, NO. 3, (456-456), Online publication date: 1-Sep-1985.Thomalla J, Lingeman J, Leapman S and Filo R (2018) The Manifestation and Management of Late Urological Complications in Renal Transplant Recipients: Use of the Urological ArmamentariumJournal of Urology, VOL. 134, NO. 5, (944-948), Online publication date: 1-Nov-1985.Barry J (2018) Unstented Extra Vesical Ureteroneocystostomy in Kidney TransplantationJournal of Urology, VOL. 129, NO. 5, (918-919), Online publication date: 1-May-1983.Goldstein I, Cho S and Olsson C (2018) Nephrostomy Drainage for Renal Transplant ComplicationsJournal of Urology, VOL. 126, NO. 2, (159-163), Online publication date: 1-Aug-1981.Warshaw B, Edelbrock H, Ettenger R, Malekzadeh M, Pennisi A, Uittenbogaart C and Fine R (2018) Renal Transplantation in Children with Obstructive UropathyJournal of Urology, VOL. 123, NO. 5, (737-741), Online publication date: 1-May-1980.Dabhoiwala N, Cate H, Linschoten H, Wilmink J and Veen J (2018) Conservative Surgical Management of Urological Complications after Cadaveric Renal TransplantationJournal of Urology, VOL. 120, NO. 3, (290-293), Online publication date: 1-Sep-1978.Greenberg S, Wein A, Perloff L and Barker C (2018) Ureteropyelostomy and Ureteroneocystostomy in Renal Transplantation: Postoperative Urological ComplicationsJournal of Urology, VOL. 118, NO. 1 Part 1, (17-19), Online publication date: 1-Jul-1977.Mcloughlin M (2018) The Ureter in Pediatric Renal AllotransplantationJournal of Urology, VOL. 118, NO. 6, (1041-1042), Online publication date: 1-Dec-1977.Schiff M, Mcguire E, Weiss R and Lytton B (2018) Management of Urinary Fistulas after Renal TransplantationJournal of Urology, VOL. 115, NO. 3, (251-256), Online publication date: 1-Mar-1976.Shenasky J (2018) Renal Transplantation in Patients with Urologic AbnormalitiesJournal of Urology, VOL. 115, NO. 5, (490-493), Online publication date: 1-May-1976.McLoughlin M (2018) Outlet Obstruction in the Transplant PatientJournal of Urology, VOL. 115, NO. 6, (632-633), Online publication date: 1-Jun-1976.Basinger G and Gittes R (2018) Lymphocyst: Ultrasound Diagnosis and Urologic ManagementJournal of Urology, VOL. 114, NO. 5, (740-745), Online publication date: 1-Nov-1975. Volume 112Issue 5November 1974Page: 561-563 Advertisement Copyright & Permissions© 1974 by The American Urological Association Education and Research, Inc.MetricsAuthor Information W.L. Marx More articles by this author N.A. Halasz More articles by this author A.P. Mclaughlin More articles by this author Ruben F. Gittes More articles by this author Expand All Advertisement PDF downloadLoading ...