Urogenital fistulas in women and men: the treatment
Not uncommon in clinical practice are urogenital fistulas, which are formed between the genital and urinary systems. This deviation is quite heavy and is observed in most of the cases in women due to severe labor with pathology. In men, complication of this type occurs generally as a result of surgical intervention. Deviation injure internal organs, violates sexual and reproductive function. In women with urogenital fistula fails of the menstrual cycle. Pathology is quite difficult to be treated, in this matter required the assistance of a qualified and experienced surgeon and gynecologist.
Genitourinary fistula is a problem that not so much brings physical pain as it causes discomfort and disrupts the usual life of women and men. Treatment of the problem is difficult, it requires experienced specialists: the urologist, the gynecologist, the surgeon. Genitourinary fistula is a channel that forms a connection between the bladder and the reproductive system. It resembles a narrow channel that is covered with epithelium or granulation tissue.
In medicine there are several classifications which distribute urinary fistula. On the origin secrete fistula obstetric and surgical. First there later surgical interventions in the urogenital system. Obstetric deviations occur as a result of ruptures of the urethra, vagina and other organs of the urogenital system.
Often obstetric urogenital fistula in women are formed after natural childbirth.
Doctors have identified inflammatory, traumatic and cancer fistula. The latter arise due to tumors. Fistulas inflammatory nature occur when rupture of the abscess, which was located in the pelvic tissue. In this case, purulent fluid gets into the urogenital tract and causes inflammation. Traumatic fistulas are the result of trauma to the pelvic organs. Distinguish the pathological process and the place of its localization:
- vaginal vesicoureteral;
- vaginal-vesical, which are located in the aisle of the bladder and vagina;
- urethrovaginal pathology, in which the fistula is formed between the urethra and the vagina;
- gallbladder and urethra-recto characterized by a connecting passage between the urethra or bladder and rectum;
- utero-ureteral occurs between the uterus and the ureter;
- utero-vesical fistula formed between the bladder and uterus.
Most often, doctors diagnose fistulas, located in the area between the urethra and the vagina. Also not uncommon are the deviations that occur between the vagina and bladder. Most often, the pathology affects women, men fistulas are formed in extremely rare cases, surgical interventions.
The main causes of urinary fistulas
Fistula in women
In women, urogenital fistulas occur after gynaecological or obstetric surgery, which ruptured the vaginal wall. This outcome is not uncommon during an abortion by an unskilled doctor. Often during the surgery with a medical instrument injured the uterine cavity, which eventually leads to the occurrence of fistula.
If a woman has a disease of the genitourinary system, accompanied by inflammation and is chronic, it is inevitable emergence of genitourinary fistula. Pathology is the result of neoplastic diseases in the internal organs of the pelvic floor or after application of radiotherapy. In some cases, the fistula in the urogenital system was congenital and is associated with abnormal development of internal organs.
Pathology in men
In men, the urinary system fistula is much less common, but occurs. Pathology arises due to injury by firearms, in the injury of the rectum in the process of operating on the prostate. Subsequently, a purulent inflammation of the tissues of the rectum or inflammatory processes in the organs of the pelvic floor in men, this problem occurs. Prostate-urethra-rectal fistula formed after the operation the perineum or rectum. In this case, it is necessary surgery to remove them.
In the formation of urinary fistula symptoms appear immediately and bother in both sexes. The most common sign of pathology is the involuntary allocation of urine. Paying attention to the degree and type of lesion, discharge may be minor and occur rarely, urine is excreted in large quantities and often. Observed these symptoms:
- Inflammation of the mucous membrane of the genital organs. This is due to the penetration of urine. Otherwise, there vaginitis due to disturbed microflora.
- Infection, penetrating into the bladder, which causes cystitis, but after some time to the occurrence of pyelonephritis.
Once detected the spontaneous secretion of urine, you should immediately consult a doctor and undergo diagnosis.
Fistulas have a negative impact on human health, they cause inflammation and various infectious diseases. In the absence of treatment there is redness on the skin near the perineum and thighs. The patient worries burning pain during urination and pain in the genitals. In this case, frequent spontaneous secretion of urine leads to unpleasant and stable odor.
If you suspect a fistula should immediately contact to a gynecologist, who when examination detects an inflammatory process and pathology. The doctor prescribes to vaginography, which is in the x-ray examination of the uterus with the use of contrast fluid. Also, the patient is zistografii in which the doctor injects contrast fluid into the cavity of the bladder. Using survey data to define the shape of the fistula.
Often in medicine, the use of this method of diagnosis, such as cystoscopy, which make the inspection of the mucosa. The procedure involves the insertion of a cystoscope into the urethra and a thorough inspection. The patient is mandatory is sent to the ultrasound examination of the pelvic floor. Using ultrasound learn about the presence of the disease and its form, and also the study allows to detect cancer pathologies at an early stage.
Treatment of fistulas
Treatment of urinary fistulas is carried out in several ways, but doctors recommend immediately carry out the operation. Conservative treatment of urinary fistulas is carried out only if the point character pathology and the fistula is not more than 3 mm in diameter. Patient install the catheter into the bladder, vagina, and other sore area and injected a saline solution for rinsing. Doctors say that the effectiveness of drug treatment rather dubious. In any case, we recommend surgical therapy.
Before surgery is definitely an antibacterial treatment to eliminate the causes of inflammation in the genitourinary system. Because the presence of inflammation can adversely affect the results of the surgery and the rehabilitation process. The operation aims to disconnect the fistula from the tissues of internal organs of the pelvic floor. Surgical intervention is performed through the vagina, the bladder or produce abdominal incision. With the help of modern equipment and skilled professionals to solve the problem and regain health.
After surgery of any type and complexity of the patient set urethral catheter is not less than 14 days. This procedure helps to avoid infection of the surgical wound. If the patient earlier than two weeks from being discharged from the hospital, he is given instructions how to care for the catheter. Before the next installation, you must enter an antiseptic in small quantities. This will help avoid cystitis. If the operation is made through the vagina, the patient is prescribed to make bandages with ointment to restore the mucosa. This rehabilitation helps to prevent re-inflammation of the genitourinary system.
Diet and lifestyle
Because after surgery, the patient must wear for a long period of time, the catheter, the sexual life is excluded for this period. After the removal of catheter is recommended to avoid sexual contact until then, until the restoration of the mucous membrane of the damaged organ. Abuse of this recommendation leads to the rupture of the scar and recurrence.
In the pathology of this nature, there is no regulation to comply with a special diet. It is recommended to limit the amount of consumption of liquid and food, which provokes to frequent trips to the toilet. Because heavy drinking increases the pressure in mocovice in which the scar longer and more painful healing.
Preventive measures should be aimed at causes that lead to the formation of fistulas. The first is to prevent inflammatory processes in the urogenital system, and if they occur, promptly seek medical help. Women in the case of abortion it is highly recommended not to use the services of dubious doctors who perform the procedure at home.