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Urethral Fistula


Presentation

  • A 3-year-old male child was presented with the history of passage of urine coming from the undersurface of penis and its tip since birth. An opening was present on the ventral aspect of midshaft of penis through which a catheter could be passed.[ncbi.nlm.nih.gov]
  • A review of the literature is presented.[ncbi.nlm.nih.gov]
  • Abstract A new technique for the repair of a urethral fistula at the penoscrotal junction is presented. Under local anaesthesia we have successfully repaired six of these fistulae using a groin island pedicle flap.[ncbi.nlm.nih.gov]
  • It is concluded that the presented surgical technique may provide a functioning internal sphincter in at least some patients with high anal atresia with recto-urethral fistula.[ncbi.nlm.nih.gov]
  • We present the case of an iatrogenic fistula treated by a transanal endoscopic microsurgical approach, without recourse to a stoma.[ncbi.nlm.nih.gov]
Multiple Congenital Anomalies
  • Benefits, and Psychological Effects of Surgery and Anesthesia, ‏ الصفحة 61 - Smith DW, Lemli L, Opitz JM: A newly recognized syndrome of multiple congenital anomalies. J Pediatr 1964;64:210-217. ‏[books.google.com]
Falling
  • These dressings often will fall off by themselves, and this is not a cause for concern. The only concern would be if the dressing bunches at the base of the penis and acts as a tourniquet.[chp.edu]
Excitement
  • When the first sex partner has experience with other guys, there can be a certain amount of bewilderment, or rejection, or excitement about trying something new.[steadyhealth.com]
Urinary Incontinence
  • None of the patients experienced fecal or urinary incontinence. All patients obtained complete fistula healing.[ncbi.nlm.nih.gov]
  • Female Urinary Incontinence Male Urinary Incontinence Pelvic Organ Prolapse Urinary Tract Infection About our Incontinence Center Sexual Function & Infertility Epididymitis / Orchitis Erectile Dysfunction -Nonsurgical Management Erectile Dysfunction -[mciverclinic.com]
  • Severe urinary incontinence is often the postoperative problem despite of fascial sling procedures.[urology-textbook.com]
  • incontinence Overflow Reflex Urge } } } incontinence Excludes: enuresis NOS ( R32 ) urinary incontinence (of): · NOS ( R32 ) · nonorganic origin ( F98.0 ) N39.8 Other specified disorders of urinary system N39.9 Disorder of urinary system, unspecified[apps.who.int]
  • Vesico-vaginal and urethro-vaginal fistula result in severe urinary incontinence because there is uncontrollable leakage of urine through the fistula which bypasses the urethra and the sphincter.[urocenterofnewyork.com]
Urethral Disease
  • Imaging of urethral disease: a pictorial review. Radiographics 2004;24:S195-S216. [ CrossRef ] [ Pubmed ] Hanus T. Rectourethral fistulas. Int Braz J Urol 2002;28:338-345. [ Pubmed ] Gupta V, Sharma SB.[ijcasereportsandimages.com]

Workup

  • Preoperative evaluation of the patient should consist of a complete bladder-urethra workup including urodynamics, cystoscopy, urethroscopy, and urine culture. Points of Caution. The margins of the fistula must be brought together without tension.[atlasofpelvicsurgery.com]

Treatment

  • Our method seems to be feasible and effective for the treatment of complex recto-urethral fistula.[ncbi.nlm.nih.gov]
  • However, early diagnosis and treatment of the metabolic derangement are of importance as it may determine the infant's overall prognosis.[ncbi.nlm.nih.gov]
  • This treatment produced complete closure, verified by MRI, of all the fistula tracts, which was still maintained after three years, and with normal anal continence.[ncbi.nlm.nih.gov]
  • In the patient with hidradenitis suppurativa and urethral fistula formation adequate surgical treatment was not technically feasible and treatment had to be continued for at least 2 years without permanent cure in sight.[ncbi.nlm.nih.gov]
  • Repair of these fistulas is difficult, especially when previous treatment includes radiation therapy to the prostate. Various operative approaches have been described to close these inaccessible fistulas.[ncbi.nlm.nih.gov]

Prognosis

  • Underlying Crohn's disease and previous radiation are associated with poor prognosis.[ncbi.nlm.nih.gov]
  • However, early diagnosis and treatment of the metabolic derangement are of importance as it may determine the infant's overall prognosis.[ncbi.nlm.nih.gov]
  • A search of the literature confirms that this differentiation is important as the cases with fistulous involvement of internal organs tend to have a bad prognosis.[ncbi.nlm.nih.gov]

Etiology

  • The patients (including those reported in the literature) were characterized by age, origin, location of calculus, size of calculus, fistulous track, and etiological factors.[ncbi.nlm.nih.gov]
  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • The prevailing hypothesis advanced for the etiology of hypospadias postulates a deficiency of testicular evocator substance prior to complete formation of the urethra.[ncbi.nlm.nih.gov]
  • A case of congenital urethral fistula with an intact glanular urethra without chordee is reported with a discussion of the possible etiology and one-stage repair.[ncbi.nlm.nih.gov]
  • الصفحة 122 - Study of the incidence of hypospadias in Rochester, Minnesota, 1940-1970, and a casecontrol comparison of possible etiologic factors. Mayo. Clin. Proc. ‏ الصفحة 338 - In: Gillenwater JY, Grayhack JT, Howards SS, Duckett JW, eds.[books.google.com]

Epidemiology

  • Epidemiological study of vesico-vaginal fistulas in Ethiopia. Int Urol J 1993;4:278–81. 2. Browning A. A new method for preventing residual urinary incontinence after successful closure of vesico-vaginal fistula. BJOG 2004;111:357–61. 3.[rcog.org.uk]
  • Epidemiology of diverticular disease – systematic review of the literature. Chirurgia (Bucur) 2015 ; 110 : 9 – 14. 2. Operative treatment of recurrent or complicated diverticulitis. J. Gastrointest Surg 2008 ; 12 : 1321 – 3. 3.[academic.oup.com]
Sex distribution
Age distribution

Prevention

  • Although such an occurrence is rare, the edematous perineum in patients with burn injuries should be managed carefully to prevent a tear at the penoscrotal junction.[ncbi.nlm.nih.gov]
  • Treatments For malformations that involve the mixing of urine and feces, treatment will first focus on diverting the feces away from the urethra to prevent infection and other complications.[cedars-sinai.edu]
  • Learn more » Vascular Surgery Offering comprehensive care of vascular disease through preventive services, diagnostic expertise, minimally invasive therapies and traditional surgical techniques.[surgery.usc.edu]
  • A perineal compression dressing is applied for 2 days to prevent subcutaneous haematoma. The patient is given no food or drink until bowel function returns; thereafter a regular diet can be resumed.[onlinelibrary.wiley.com]
  • It is sobering to remember that this long-term suffering could have been easily prevented if the woman had been able to get to a hospital for a timely and safe delivery.[rcog.org.uk]

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