Comparison of transvesical repair of vesico-vaginal fistula and use of free bladder mucosal graft

This study was designed to compare the efficacy and complications of the conventional transvesical repair of vesicovaginal fistula versus new technique using free bladder mucosal graft for repair. It was carried out on 16 patients aged 16-45 years in the Departments of Urology, Services Hospital and Jinnah Hospital, Lahore from 1999 to 2001. Patients were randomly divided into two groups A and B. In group A, 8 patients who underwent conventional transvesical repair of.vesicovaginal fistula whereas in group B, 8 patients who underwent repair using free bladder mucosal graft. Out of 16 patients, the recurrence was observed in 3 patients [37.5%] in group A and i patient in group B, [12.5%]. There was statistically no significant difference P > 0.05. The transvesical free bladder mucosal graft repair provides good result with minimum complications. This method is recommended for routine repair of vesicovaginal fistulae without extensive dissection of the diseased area

Management of vesicovaginal fistula with use of free bladder mucosal graft

The use of free bladder mucosal graft for repair of vesicovaginal fistula as a routine procedure as it is simple and less time consuming procedure. This study was carried out on 10 patients aged 25-40 years in the Department of Urology, Bolan Medical Complex Hospital, Quetta, during 20.12.2006 to 19.12.2007. Detailed history was taken to record age, nature of trauma and time interval of appearance of fistula. Leakage was noted in one patient after the removal of foleys catheter and a trial of re-drainage attempted with foleys but no any improvement noted, although all other were dry. The free bladder mucosal graft technique is a simple, effective and fast method for vesicovaginal fistula repair. The technique produces an excellent repair of vesicovaginal fistula with good results

Calculus related acute renal failure; management strategies

Background: Urolothises is one of the most common and oldest diseases of urinary tract. It is endemic Pakistan and the incidence of calculus renal failure is high. This is due to poor initial management

Methods: it is an observational study conducted at the Department of Urology, Services Hospital, Lahore from April 2001 to March 2003. In this study we evaluated the patients with calculus renal failure regard“; their preoperative, operative, postoperative management and improvement in renal function after the removal of stones. Twenty patients, 13 male and 7 female were included in this study. The chief presenting symptom was anuria in 20 [100%] of patients. Ultrasonography, X-ray KUB and Ante-grade pyeiogrqahy were the main investigations regarding the site, size of stone, degree of hydronephrosis and echogenicty of the kidneys. Percuta-neous Nephrostomy alone, Acute Peritoneal Dialysis alone and Pereutaneous Nephrostomy with Acute Peritoneal Dialysis were the emergency procedures performed to save the lite ot the patients and to plan for a definite surgical procedure. After the stabilization of the renal function. definite surgical procedure in the tom of pyelo-lithotomy and ureterolithotomy were performed

Results: Results were analyzed by considering the duration of anuria, degree of obstruction [hydrawephmsis] and duration of maximum improvement. Overall thirteen [65%] patients had good result five [25%] patients had satisfactory results and two [10%] patients had poor results. Anuria due to stones in the unnary tract is a urological emergency

Conclusion: Prompt and early interventions can save the patient from developing irreversible renal damage