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Fulltext Ureterovaginal fistula: A complication of a vaginal foreign body

Lo TS, Jaili SB, Ibrahim R, Kao CC, Uy-Patrimonio MC

Taiwan J Obstet Gynecol, 2018 Feb;57(1):150-152.
PMID: 29458888 DOI: 10.1016/j.tjog.2017.12.026

OBJECTIVE: To know the diagnostic tools and proper management of ureterovaginal fistula following neglected vaginal foreign body in order to achieve optimal outcome.
CASE REPORT: A case of ureterovaginal fistula associated with a neglected vaginal foreign body. The patient was complaining of a foul-smelling vaginal discharge and lower abdominal pain. On vaginal examination, a hard and large foreign body was found. Examination under anesthesia was performed, and an aerosol cap was removed from her vagina. The patient developed urinary incontinence after removal of the foreign body. Subsequent work-up demonstrated the presence of a right ureterovaginal fistula. The patient underwent an abdominal ureteroneocystostomy. At one year follow up, the patient had fully recovered.
CONCLUSION: Ureterovaginal fistula following neglected vaginal foreign body is a serious condition. Early diagnosis, treatment of infection and proper surgical management can improve the outcome and decrease complications.

Matched MeSH terms: Urinary Fistula/complications*; Urinary Fistula/etiology; Urinary Fistula/surgery
Fulltext A complicated urethrovaginal fistula following an inappropriate urethral diverticulum management

Lo TS, Jaili SB, Ibrahim R

Taiwan J Obstet Gynecol, 2017 Aug;56(4):534-537.
PMID: 28805613 DOI: 10.1016/j.tjog.2016.10.004

OBJECTIVE: Urethral diverticulum is uncommon, therefore appropriate evaluation, preoperative planning and counseling must be done in order to make correct diagnosis and prevent complications.
MATERIALS AND METHODS: A case of anterior vaginal wall mass was treated elsewhere by a gynecologist as periurethral cyst abscess; incision and drainage were done but a symptom of pus discharge was observed after 2 weeks. Therefore, exploration, cyst wall excision and primary closure were done though histopathological examination surprisingly confirmed the presence of urethral tissue suggestive of diverticulum.
RESULTS: Subsequently, she developed persistent urinary leakage along with urethrovaginal fistula for which they again performed pervaginal multilayer closure. Patient was later referred to us with recurrent urethrovaginal fistula. We performed posterior urethral fistulectomy with anterior vaginal wall flap and multilayer closure. Three years follow up reveals complete recovery.
CONCLUSION: Even urethral diverticulum is a rare condition, should be kept in mind as early diagnosis and management.

Matched MeSH terms: Urinary Fistula/etiology; Urinary Fistula/surgery*
Lethal hemorrhage from a ureteric-arterial-enteric fistula diagnosed by postmortem CT angiography

Rashid SN, Bouwer H, O'Donnell C

Forensic Sci Med Pathol, 2012 Dec;8(4):430-5.
PMID: 22477359 DOI: 10.1007/s12024-012-9332-3

Fistula formation following pelvic surgery and radiotherapy, including ureteric-arterial fistulas (UAF), is well documented, however, ureteric-arterial-enteric fistula is extremely rare. Conventional autopsy is usually required for the definitive diagnosis of pelvic vascular fistulas although an accurate diagnosis can still be complicated and challenging. The role of post-mortem computed tomography (PMCT) as an adjunct to conventional autopsy is well documented in the literature. One of the limitations of PMCT is the diagnosis of vascular conditions. Post-mortem computed tomography angiography (PMCTA) is a recently introduced technique that can assist in detecting such pathology. We present a case of post-radiotherapy ureteric-arterial-enteric fistula presenting as massive rectal and vaginal bleeding diagnosed prior to autopsy on PMCTA. The role of PMCTA in the diagnosis of such a UAF has not previously been reported in the literature.

Matched MeSH terms: Urinary Fistula/diagnosis*
Robotic-assisted laparoscopic ureteral reimplantation with psoas hitch: a multi-institutional, multinational evaluation

Patil NN, Mottrie A, Sundaram B, Patel VR

Urology, 2008 Jul;72(1):47-50; discussion 50.
PMID: 18384858 DOI: 10.1016/j.urology.2007.12.097

To report the collective experience of three multinational institutions with the use of robotics to evaluate and treat complex distal ureteral obstruction.

Matched MeSH terms: Urinary Fistula/surgery
Fulltext CT appearances of Marjolin's ulcer in the left gluteal region of a young man

Mohamed S, Abdullah B, Singh DA, Heng KS

Biomed Imaging Interv J, 2006 Jul;2(3):e26.
PMID: 21614240 DOI: 10.2349/biij.2.3.e26

Chronic wounds and scar tissues are prone to skin cancer. In 1828, Jean-Nicholas Marjolin described the occurrence of tumours in post-traumatic scar tissue. He did not, however, identify the warty ulcers he described as malignant. It was Dupuytren, who about two years later, noted that these lesions were cancerous. The eponym was bestowed by Da Costa in 1903. Marjolin's ulcer no longer refers only to carcinomas secondary to burns and is classified as a malignancy that arises from previously traumatised, chronically inflamed, or scarred skin. It has been reported in relation to osteomyelitis, venous stasis ulcer, tropical ulcers, chronic decubitus ulcer, frostbite, pilonidal sinus, vaccination site, urinary fistula, hidradenitis suppurativa, skin graft donor site, gunshot wounds, puncture wounds, dog bites, and lupus rash. Early arising Marjolin's ulcer has rarely been described in literature. In this case report, we present the CT appearances of Marjolin's ulcer in the left gluteal region of a young man.

Matched MeSH terms: Urinary Fistula