Transvaginal repair of complex and complicated vesicovaginal fistulae.

Objective: To document the experience at a tertiary referral hospital in India with managing complex and complicated vesicovaginal fistulae (VVF) by the transvaginal route, and to document the complications and the long-term outcome of the patients.

Methods: The medical records of 102 patients with complex or complicated VVF who underwent transvaginal surgical repair during 2000-2009 were reviewed retrospectively.

Results: The mean age of the patients was 24 years and the mean duration of urinary incontinence was 3 years (range 6 months to 12 years).

Cystohysteroscopy: novel use of semi-rigid ureteroscope to establish an access via fistulous tract between urinary bladder and vagina for confirming the diagnosis and facilitating laparoscopic repair of vesicouterine fistula.

In patients with vesicouterine fistula (VUF), identification of the fistulous tract during laparoscopic surgery remains difficult. Hysterography and intravesical instillation of dye have been the traditional methods for diagnosing VUF; now, they have been supplanted by ultrasonography, CT, and/or MRI. Unfortunately, none of the above mentioned investigations aid in identification of the fistulous tract during laparoscopic surgery or ease laparoscopic dissection.

Primary menouria due to a congenital vesico-vaginal fistula with distal vaginal agenesis: a rarity.

We present the case of a female aged 16 years, suffering from cyclical menouria for the last 3 years. Clinical examination revealed the absence of a vagina. Cystoscopy performed while the patient was having menouria revealed an orifice (10 × 8 mm) in the supratrigonal region; blood clots were entering the urinary bladder through this orifice.

A complicated true sliding hernia presenting as a spontaneous enteroscrotal fistula in an adult.

A 26-year-old man presented with an irreducible right inguino-scrotal swelling and fecal discharge from the scrotum. Exploratory laparotomy and inguinal exploration revealed that the caecum, appendix, and terminal ileum had herniated into the scrotum and had perforated through the skin forming a fecal fistula. The herniated gangrenous bowel was resected and a stoma fashioned.