Genital tract fistula Flashcards

1
Q

Definition

A

Abnormal opening that forms between two organs or tissues in the reproductive tract.
Typically between the vagina and another nearby structure, such as the bladder, rectum, or uterus.

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2
Q

Aetiology

A
  • Obstetric fistula (MC): They occur when prolonged labour or difficult childbirth causes a tear between the vagina and bladder or rectum
  • Surgical complications: After gynaecological surgeries e.g. hysterectomy or c-section. In some cases the surgeon may accidentally damage the bladder or rectum during the procedure
  • IBD: Can cause inflammation and ulcers in the intestines, which can lead to fistula formation between rectum and vagina
  • Radiation therapy
  • Infections: e.g. TB can cause scarring and damage to the tissues of the reproductive system, leading to fistula formation
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3
Q

Risk factors

A

Prolonged labour
Pelvic surgery
Radiation therapy
IBD
STI’s
FGM

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4
Q

Symptoms

A
  • Urine leakage
  • Faecal leakage
  • Vaginal discharge
  • Recurrent urinary and vaginal infections
  • Pain
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5
Q

Diagnosis

A
  • Pelvic exam
  • Imaging tests e.g. CT, MRI
  • Urodynamic studies
  • Cystoscopy/sigmoidoscopy
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6
Q

Management

A
  • Referral to a specialist
  • Conservative management: (mild symptoms)
    = pelvic floor muscle training
    = the use of absorbant pads
  • Surgical management
    = flap-splitting method (vaginal)
    = latzko procedure
    = transperitoneal transvesical repair
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