3 research outputs found
Vaginocutaneous fistula and inguinal abcess presented 6 years after tension-free vaginal tape sling
Surgical treatment of female stress urinary incontinence (SUI) has become very pop- ular after respectable success with minimal invasive surgeries. This is the first report of long term vaginocutaneous fistula (VCF) plus inguinal abcess after tension-free vaginal tape (TVT). A 67 year-old woman with vaginal discharge lasting more than 3 years complained with a painful swelling in the left inguinal area for the last three months. She had a medical history of TVT sling procedure for SUI six years ago. She had no history of pelvic surgery, cancer treatment or pelvic irradiation before or after TVT sling. No urethrovaginal or vesicovaginal fistula was found in physical examination and cystocopy. MRI showed a vaginocutenaous fistula and inguinal abcess. This case highlights the need for a high index of suspicion for VCF after TVT
Surgical repair of the iatrogenic falsepassage in the treatment of trauma-induced posterior urethral injuries
Pelvic fracture associated urethral injury (PFAUI) is a rare and challenging sequel of blunt pelvic trauma. Treatment of iatrogenic false urethral passage (FUP) remains as a challenge for urologists. In this case report we reviewed the iatrogenic FUP caused by wrong procedures performed in the treatment of a patient with PFAUI and the treatment of posterior urethral stricture with transperineal bulbo-prostatic anatomic urethroplasty in the management of FUP. A 37-year-old male patient with PFAUI had undergone a laparotomy procedure for pelvic bone fracture, complete urethral rupture, and bladder perforation 8 years ago. After stricture formation, patient had undergone procedures that caused FUP. Following operations, he had a low urinary flow rate, and incontinence and urgency even with small amounts of urine. FUP was diagnosed by voiding cystourethrography and retrograde urethrography. FUP was fixed with open urethroplasty with the guidance of flexible antegrade urethtoscopy. False passage should always be taken into account in the differential diagnosis of patients with persistent symptoms that underwent PFAUI therapy. In addition, we believe that in the evaluation of patients with PFAUI suspected for having a false passage, bladder neck and urethra should be assessed by combining routine voiding cystourethrography and retrograde urethrography with preoperative flexible cystoscopy via suprapubic route
Prospective comparison of ligation and bipolar cautery technique in non-scalpel vasectomy
Objectives: There is no trial comparing bipolar cautery and ligation for
occlusion of vas in non-scalpel vasectomy. This study aimed to compare
the effectiveness of these vasectomy occlusion techniques.
Materials and Methods: Between January 2002-June 2009, patients were
allocated in alternate order. We recruited 100 cases in cautery group
and 100 cases in ligation group. Non-scalpel approach was performed
during vasectomy and fascial interposition was performed in all cases.
First semen analysis was done 3 months after vasectomy. Vasectomy
success was defined as azoospermia or non-motile sperm lower than
100.000/mL.
Results: Four patients from the cautery group were switched to the
ligation group due to technical problem of cautery device. Thus, data of
96 patients as cautery group and 104 patients as ligation group were
evaluated. After vasectomy, semen analyses were obtained from 59 of 96
(61.5\%) patients in cautery group and to 66 of 104 (63.5\%) patients in
ligation group. There was no statistical significant difference between
the two groups in terms of the success of vasectomy (p=0.863).
Conclusion: Although bipolar cautery technique is safe, effective and
feasible in non-scalpel vasectomy, it has no superiority to ligation.
There was no statistically significant difference in terms of the
success and complications between the two groups