Early cystoscopic examination in yesicovaginal fistulae, Is it a must?

ABSTRACT

This study was performed on ten female patients who were exposed to total abdominal hysterectomy, and suffering from early postoperative [2-7 days] leakage of urine through the vagina. Cystoscopy was done for all cases and showed traumatic lesion in the bladder mucosa with a stitch in 6 cases and shready necrotic defect in the posterior bladder wall in the remaining 4 cases. Supratrigonal shreds and necrotic mucosa were found over the suture material [vicryl] in 6 cases. Via cystoscopy the suture thread was cut using the cold-knife resectoscope, bilateral ureteric catheters number 8 Fr were introduced and fixed, and a silicon urethral catheter was fixed while urine diversion via urethra catheter was done to the other 4 cases. Follow-up with methylene blue [MB] test was done weekly. MB test was -ve in 8 cases after 3 weeks. Two cases did not improve and were operated upon 3 months later