Voiding dysfunction after repair of giant trigonal vesicovaginal or urethrovesicovaginal fistulae: A need for long-term follow-up
Introduction: Urodynamic findings of lower urinary tract of women presenting with voiding dysfunction after successful repair of complex trigonal vesicovaginal fistulas at our institute are presented. Materials and Methods: In this retrospective case series, women presenting with voiding dysfunction...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2012-01-01
|
| Series: | Indian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.indianjurol.com/article.asp?issn=0970-1591;year=2012;volume=28;issue=4;spage=405;epage=408;aulast=Agarwal |
| _version_ | 1819069256612970496 |
|---|---|
| author | Mayank Mohan Agarwal Sathishkumar Mothilal Raamya Ravimohan Mavuduru Arup K Mandal Shrawan K Singh |
| author_facet | Mayank Mohan Agarwal Sathishkumar Mothilal Raamya Ravimohan Mavuduru Arup K Mandal Shrawan K Singh |
| author_sort | Mayank Mohan Agarwal |
| collection | DOAJ |
| description | Introduction: Urodynamic findings of lower urinary tract of women presenting with voiding dysfunction after successful repair of complex trigonal vesicovaginal fistulas at our institute are presented.
Materials and Methods: In this retrospective case series, women presenting with voiding dysfunction after successful repair of obstetric fistulae were evaluated. In addition of standard clinical evaluation with history and clinical examination, all underwent kidney-ureter-bladder ultrasonography, renal function test, urine culture, and multichannel urodynamics. The latter consisted of free uroflowmetry, filling and voiding cystometry.
Results: Five women (median age 35 years; range 30-45) presented with difficulty in voiding after the successful repair; two presented within 1 year and 3 after 10 years. The latter three presented with bilateral hydroureteronephrosis; one of these had chronic kidney disease (CKD) grade IV at presentation. Urodynamics (UDS) of all patients revealed poor detrusor compliance (median 11 ml/cm H 2 O; range 5-22), high-end filling detrusor pressures (median 41 cm H 2 O; range 11-46) and no detrusor overactivity. All patients attempted voiding with abdominal straining; with little contribution of detrusor contraction (median 6 cm H 2 O; range 0-9). Two patients could not void during the study, one with Tanagho reconstruction and another with CKD.
Conclusion: Even after successful repair, patients with complex trigonal or urethra-vesicovaginal fistulae warrant indefinite long-term follow-up for voiding dysfunction in view of possibility of developing poorly compliant bladder. |
| first_indexed | 2024-12-21T16:47:09Z |
| format | Article |
| id | doaj.art-94f21db7321b4238b4f99c32b2e2b375 |
| institution | Directory Open Access Journal |
| issn | 0970-1591 1998-3824 |
| language | English |
| last_indexed | 2024-12-21T16:47:09Z |
| publishDate | 2012-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Urology |
| spelling | doaj.art-94f21db7321b4238b4f99c32b2e2b3752022-12-21T18:56:57ZengWolters Kluwer Medknow PublicationsIndian Journal of Urology0970-15911998-38242012-01-0128440540810.4103/0970-1591.105751Voiding dysfunction after repair of giant trigonal vesicovaginal or urethrovesicovaginal fistulae: A need for long-term follow-upMayank Mohan AgarwalSathishkumar Mothilal RaamyaRavimohan MavuduruArup K MandalShrawan K SinghIntroduction: Urodynamic findings of lower urinary tract of women presenting with voiding dysfunction after successful repair of complex trigonal vesicovaginal fistulas at our institute are presented. Materials and Methods: In this retrospective case series, women presenting with voiding dysfunction after successful repair of obstetric fistulae were evaluated. In addition of standard clinical evaluation with history and clinical examination, all underwent kidney-ureter-bladder ultrasonography, renal function test, urine culture, and multichannel urodynamics. The latter consisted of free uroflowmetry, filling and voiding cystometry. Results: Five women (median age 35 years; range 30-45) presented with difficulty in voiding after the successful repair; two presented within 1 year and 3 after 10 years. The latter three presented with bilateral hydroureteronephrosis; one of these had chronic kidney disease (CKD) grade IV at presentation. Urodynamics (UDS) of all patients revealed poor detrusor compliance (median 11 ml/cm H 2 O; range 5-22), high-end filling detrusor pressures (median 41 cm H 2 O; range 11-46) and no detrusor overactivity. All patients attempted voiding with abdominal straining; with little contribution of detrusor contraction (median 6 cm H 2 O; range 0-9). Two patients could not void during the study, one with Tanagho reconstruction and another with CKD. Conclusion: Even after successful repair, patients with complex trigonal or urethra-vesicovaginal fistulae warrant indefinite long-term follow-up for voiding dysfunction in view of possibility of developing poorly compliant bladder.http://www.indianjurol.com/article.asp?issn=0970-1591;year=2012;volume=28;issue=4;spage=405;epage=408;aulast=AgarwalDetrusor compliancegiant vesicovaginal fistulaneurogenic bladder |
| spellingShingle | Mayank Mohan Agarwal Sathishkumar Mothilal Raamya Ravimohan Mavuduru Arup K Mandal Shrawan K Singh Voiding dysfunction after repair of giant trigonal vesicovaginal or urethrovesicovaginal fistulae: A need for long-term follow-up Indian Journal of Urology Detrusor compliance giant vesicovaginal fistula neurogenic bladder |
| title | Voiding dysfunction after repair of giant trigonal vesicovaginal or urethrovesicovaginal fistulae: A need for long-term follow-up |
| title_full | Voiding dysfunction after repair of giant trigonal vesicovaginal or urethrovesicovaginal fistulae: A need for long-term follow-up |
| title_fullStr | Voiding dysfunction after repair of giant trigonal vesicovaginal or urethrovesicovaginal fistulae: A need for long-term follow-up |
| title_full_unstemmed | Voiding dysfunction after repair of giant trigonal vesicovaginal or urethrovesicovaginal fistulae: A need for long-term follow-up |
| title_short | Voiding dysfunction after repair of giant trigonal vesicovaginal or urethrovesicovaginal fistulae: A need for long-term follow-up |
| title_sort | voiding dysfunction after repair of giant trigonal vesicovaginal or urethrovesicovaginal fistulae a need for long term follow up |
| topic | Detrusor compliance giant vesicovaginal fistula neurogenic bladder |
| url | http://www.indianjurol.com/article.asp?issn=0970-1591;year=2012;volume=28;issue=4;spage=405;epage=408;aulast=Agarwal |
| work_keys_str_mv | AT mayankmohanagarwal voidingdysfunctionafterrepairofgianttrigonalvesicovaginalorurethrovesicovaginalfistulaeaneedforlongtermfollowup AT sathishkumarmothilalraamya voidingdysfunctionafterrepairofgianttrigonalvesicovaginalorurethrovesicovaginalfistulaeaneedforlongtermfollowup AT ravimohanmavuduru voidingdysfunctionafterrepairofgianttrigonalvesicovaginalorurethrovesicovaginalfistulaeaneedforlongtermfollowup AT arupkmandal voidingdysfunctionafterrepairofgianttrigonalvesicovaginalorurethrovesicovaginalfistulaeaneedforlongtermfollowup AT shrawanksingh voidingdysfunctionafterrepairofgianttrigonalvesicovaginalorurethrovesicovaginalfistulaeaneedforlongtermfollowup |