Subject(s)
Aged , Humans , Male , Colonic Diseases/therapy , Fibrin Tissue Adhesive/administration & dosage , Intestinal Fistula/therapy , Lithotripsy/adverse effects , Urinary Fistula/therapy , Colonic Diseases/etiology , Fluoroscopy , Intestinal Fistula/etiology , Intestinal Perforation/etiology , Kidney Calculi/therapy , Nephrostomy, Percutaneous/adverse effects , Urinary Fistula/etiologyABSTRACT
A ruptura ou fistulização de vasos linfáticos para o interior do sistema excretor urinário dá origem à quilúria, que tem na bancroftose a sua principal etiologia. Pode ser, raramente, também causada por neoplasia, malformação linfática, traumatismo abdominal, assim como outras doenças infecciosas como a tuberculose. Os autores propõem as diretrizes gerais para a condução do portador de "urina leitosa" em áreas endêmicas e não endêmicas de filariose bancroftiana. Ressaltam a importância dos exames de triagem e de outros mais sofisticados para uma investigação etiológica a partir da realização de anamnese e de exame físico criteriosos. Enfatizam a necessidade de que a doença deve ser conduzida através de uma abordagem mais abrangente, que compreenda, além da médica, a assistência social e a nutricional. Na grande maioria dos casos, o controle da quilúria está basicamente fundamentado na educação e na adequação do paciente a uma dieta hipolipídica/hiperprotéica e rica em líquidos.
The rupture or fistulization of lymph vessels into the urinary system, known as chyluria (milky urine), is caused mainly by bancroftian filariasis. On rare occasions chyluria may also be caused by neoplasia, lymphatic malformation, abdominal trauma, as well as other infectious diseases such as tuberculosis. The authors proposed general guidelines to manage patients suffering from milky urine in Bancroftian filariasis endemic and non-endemic areas. They emphasized the importance of a careful diagnostic process accomplished using screening procedures, evaluating a detailed history of illness and performing a careful physical examination, targeting on the most suitable diagnostic tools for each case. In addition, they emphasized the need to manage the patient from a broader perspective, which goes beyond the medical aspect, involving also social and nutritional contexts. In the great majority of cases, controlling chyluria is fundamentally based on patient education and adjustment to a low lipid, high protein diet in addition to increased fluid intake.
Subject(s)
Animals , Humans , Chyle , Urinary Fistula , Diagnosis, Differential , Diet , Urine , Urinary Fistula/diagnosis , Urinary Fistula/etiology , Urinary Fistula/therapy , Wuchereria bancroftiABSTRACT
OBJECTIVES: urinary fistula is a morbid complication after renal transplantation leading to graft losses and patient death. We review and update our data on urinary fistula after renal transplantation and the outcome after surgical and conservative management. MATERIALS AND METHODS: the charts of 1046 renal transplants were reviewed. Transplants were performed through an extended inguinotomy; vascular anastomoses to the iliac vessels and urinary reconstruction accomplished through the Gregoir technique. Fistulae were diagnosed by urinary leaks through the incision or by the occurrence of a collection in the iliac fossa. Patient was treated surgically or conservatively according to the characteristics of the fistula and patient clinical status. RESULTS: Thirty one fistulae were diagnosed (2.9 percent). Twenty nine leaks due to ureteral necrosis and 2 due to reimplantation fault. The incidence of leaks among cadaver and live donor transplants was 3.22 percent and 2.63 percent, respectively (p = 0.73). Among diabetic and non diabetic patients the incidence of urinary leaks was 6.4 percent and 2.6 percent, respectively (p = 0.049). Treatment consisted in anastomosis of the graft ureter or pelvis with the ureter of the recipient in 17 cases with success in 13 (76.5 percent). Prolonged bladder drainage was employed in 7 cases and the fistula healed in 4 (57 percent). Ureteral reimplantation was performed in 3 cases and did not work in any of them. Ureteral ligature plus nephrostomy was employed in two cases and worked in one (50 percent). Percutaneous nephrostomy and ureteral stenting with double J catheter were employed in one case each and worked in both. CONCLUSIONS: The anastomosis of the graft ureter with the ureter of the recipient is a good method for treating urinary fistulae after renal transplantation when local and systemic conditions are good. Ureteral ligature associated to nephrostomy should be applied in cases of unfavorable local conditions or clinically unstable patients.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Kidney Transplantation/adverse effects , Urinary Fistula/surgery , Follow-Up Studies , Retrospective Studies , Treatment Outcome , Urinary Fistula/etiology , Urinary Fistula/therapyABSTRACT
Purpose: to analyze the different aspects of urinary fistulas. Design: retrospective observational clinical study. Methods: we evaluated 50 cases comparing different aspectis as etiology, incidence, diagnosis, treatment and success rate... This study demonstrates the high rate of successful closure of the urinary fistula, but highlight the knowledge that we should have of the incidence, etiology, diagnosis and treatment of this urological problem
Subject(s)
Humans , Diagnostic Techniques, Urological , Urinary Fistula/diagnosis , Urinary Fistula/etiology , Urinary Fistula/therapy , Vesicovaginal Fistula/diagnosis , Vesicovaginal Fistula/etiology , Vesicovaginal Fistula/therapyABSTRACT
Se presenta el caso clínico de un paciente masculino de 55 años de edad, quien ocho días después de someterse a plastia inguinal izquierda presentó fístula vesicoinguinal izquierda que se comprobó con estudios radiológicos. Se trató al paciente con sonda transuretral y antisépticos urinarios durante dos semanas. Dada la rareza del caso, se realizó una minuciosa revisión de la literatura
Subject(s)
Humans , Male , Middle Aged , Urinary Fistula/etiology , Urinary Fistula/therapy , Hernia, Inguinal/complications , Hernia, Inguinal/surgery , Postoperative Complications , Postoperative Complications/diagnosis , Urinary Bladder/injuriesABSTRACT
Revisam-se aspectos etiopatológicos, clínicos e diagnósticos das fístulas urogenitais. Conclui-se que, em sua maioria, resultam de eventos iatrogênicos, produtores de soluçöes de continuidade que permitem fluxo urinário de vias urinárias baixas ou altas para o trato genital, Indica-se cuidadosa avaliaçäo diagnóstica de cada caso, individualizando o tratamento. Apenas cerca de 5 por cento de casos tendem à resoluçäo espontânea; nos demais, o tratamento cirúrgico oportunizará a soluçäo definitiva
Subject(s)
Humans , Female , Urinary Fistula/surgery , Urinary Fistula/diagnosis , Urinary Fistula/therapy , Urinary Bladder Fistula/surgery , Urinary Bladder Fistula/diagnosis , Urinary Bladder Fistula/therapy , Vesicovaginal Fistula/surgery , Vesicovaginal Fistula/diagnosis , Vesicovaginal Fistula/therapyABSTRACT
Se reporta el caso de un transplante renal complicado con una fístula ureteral, tratado con éxito con una pielouretertostomía del riñón transplantado al riñón natural. Se revisa la literatura encontrando que esta técnica fue reportada por primera vez por Goodwin en 1962 en presencia de un uretero lesionado y muy corto
Subject(s)
Humans , Female , Middle Aged , Ureterostomy , Urinary Fistula/therapy , Kidney Transplantation , Costa RicaABSTRACT
Se muestra la experiencia institucional de Marzo de 1992 a Mayo de 1993. Se estudiaron 11 pacientes con diagnóstico de fístula, de las cuales una fue vesico-uterina, dos urétero-vaginales y ocho vesico-vaginales. Solo a ocho pacientes se les realizó corrección quirúrgica, una de estas se abordó por la vía vaginal y siete por la vía abdominal. De las pacientes con abordaje abdominal, dos casos fueron urétero-neocistostomías. El fracaso quirúrgico se presentó en dos casos, ambos con abordaje abdominal. Estos datos ponen de manifiesto que la fístula urogenital es una complicación frecuente en pacientes sometidas a procedimientos quirúrgicos ginecológicos. El éxito quirúrgico probablemente depende más de la técnica quirúrgica que a la vía de abordaje
Subject(s)
Humans , Female , Urinary Fistula/therapy , Vaginal Fistula/therapyABSTRACT
Presentamos 10 casos de fístulas enterourinarias de diversa ubicación. La radioterapia, los traumatismos y los cánceres constituyen la causa de la mayoría de los casos. El manejo de ellas se hizo considerando la patología de base para obtener en algunos casos la curación. En la mayoría de los casos debido a la patología de base, sólo son accequibles soluciones mediocres médicamente, pero tolerables socialmente
Subject(s)
Adult , Middle Aged , Humans , Male , Intestinal Fistula/etiology , Urinary Fistula/etiology , Urinary Fistula/classification , Urinary Fistula/therapyABSTRACT
E relatado um caso de fistula vesicoarticular, comunicando bexiga com a articulaçao coxofemoral direita, de 40 anos de evoluçao, formada a partir de uma artrite septica do quatril. Foi realizada a correçao da fistula por via transperitoneal
Subject(s)
Humans , Male , Middle Aged , Urinary Fistula/therapy , Urinary Bladder Fistula/therapyABSTRACT
Os autores apresentam um caso de fístula urinária como complicaçäo da ureterossigmoidostomia. Estudam e ilustram a propedêutica e a terapêutica utilizadas para sua correçäo e comparam a derivaçäo urinária, interna com a externa. Nesta última, os dispositivos de coleta externa oneram economicamente e traumatizam psiquicamente os pacientes