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1

Large Vesico-Vaginal Fistula Caused by a Foreign Body  

PubMed Central

Foreign body is a rare cause of vesico-vaginal fistula most often reported in developed countries. In developing countries obstructed labor is the commonest cause of fistula. A nulliparous 19-year-old female presented with a 3-week history of a foreign body in the vagina causing urinary incontinence and offensive vaginal discharge. Her guardian allegedly inserted the foreign body after she refused a pre-arranged marriage. A plastic container was removed from the vagina under general anesthesia. A large vesico-vaginal fistula was discovered, which was successfully surgically repaired. We recommend urgent removal of the foreign body, preferably under general anesthesia. However, if the history or physical examination reveals prolonged exposure, repair of the fistula should be delayed to allow for adequate debridement in order to prevent any life-threatening complications.

Massinde, AN; Kihunrwa, A

2013-01-01

2

Vesico-vaginal fistula repair as a day case: is it a worthy venture?  

PubMed

Two vesico-vaginal fistula patients who were successfully managed with outpatient care as an alternative approach, to ensure early access to care and integration into their family. The two patients had simple uncomplicated mid-vagina fistulae surgically repaired with local infiltrative anaesthesia. We suggest some selection criteria and clinical guidelines that can facilitate successful treatment by this choice of care. PMID:23695384

Ojengbede, O A; Morhason-Bello, I O

2013-05-22

3

The first case of vesico-vaginal fistula in a patient with primary lymphoma of the bladder – a case report  

Microsoft Academic Search

BACKGROUND: Primary lymphoma of the bladder is a rare condition with less than 100 cases reported in the literature. CASE PRESENTATION: Here we present the case of a 64 year old woman with a 9 month history of haematuria, frequency, urinary incontinence and weight loss. Cystoscopy revealed a solid tumour throughout the whole bladder wall and a vesico-vaginal fistula. This

David A Evans; Andrew T Moore

2007-01-01

4

Reproductive performance after the repair of obstetric vesico-vaginal fistulae.  

PubMed

Between 1966 and 1976, 148 out of 162 patients with obstetrically acquired vesico-vaginal fistulae were successfully repaired in Lagos University Teaching Hospital. The reproductive performance of these patients after repair has been reviewed with special regard to menstruation, satisfactory coitus and childbearing. Before the repair of the fistulae 66 patients (40.6%) had secondary amenorrhoea ranging from 4 months to 15 years. There were 3 cases each of oligomenorrhoea and cryptomenorrhoea. After repair menstruation returned within 6 months in 58 patients. Secondary amenorrhoea is thought to be due to a combination of severe malnutrition, anaemia, endometritis, psychological upsets and occasionally endocrine malfunction due to focal anterior pituitary necrosis. Repair of the fistulae worsened gynatresia in 17 cases. Twelve patients had dyspareunia and 3 others had apareunia. Thirty-one patients achieved 38 pregnancies after repair. Thirty-two infants were delivered by lower segment Caesarean section. There were 5 vaginal deliveries and one abortion. The average birth weight was 2.96 kg. The corrected perinatal mortality was nil. Five cases had a recurrence of the fistulae after delivery and 2 others had stress incontinence. Electric lower segment Caesarean section is the ideal method of delivery. PMID:742828

Evoh, N J; Akinla, O

1978-12-01

5

Uretero-vesico-cervical fistula following a caesarean section: a unique case report.  

PubMed

A unique combined fistula involving simultaneously the bladder, ureter, and cervix following cesarean section is described. Evaluation, management, and review of the literature regarding this rare and challenging case are reported. This unique case report emphasizes the potential complexity of iatrogenic genitourinary fistulae, suggesting that these might have unexpected morphology and present with multiple fistulous components. It has been demonstrated that concomitant ureteral involvement is estimated to complicate at least 10 % of vesico-vaginal fistulae. Thus, increased awareness of the possibility of complex iatrogenic fistulae and precise evaluation of the upper urinary tract are necessary to accurately define the extent of all fistulous tracts during the initial evaluation. This in turn may enable tailored management of these challenging cases. Moreover, in the case of surgical treatment, an accurate initial definition of fistula morphology may enable a single-stage reconstructive procedure sparing additional interventions and avoiding any potential complications. PMID:22527547

Tsivian, Maria; Tsivian, Matvey; Sidi, A Ami; Tsivian, Alexander

2012-04-18

6

Trans-vaginal repair of gynecological supratrigonal vesicovaginal fistulae: A worthy option!  

PubMed Central

Objective: To determine the appropriateness of vaginal approach for gynecological supratrigonal vesicovaginal fistulae. Patients and Methods: Retrospective review of consecutive women with gynecological supratrigonal Vesico Vaginal Fistulae (VVF) repaired at the fistula unit of Urogynecology department between 1996 and 2011 was done.Out of 48 cases of supratrigonal VVF of gynecological origin identified; 34 (70.8%) cases were repaired vaginally and 14 (36.8%) abdominally with a mean follow-up period of 52.8 (2-132) months. Results: Overall 95.8% were successfully cured at first attempt. The success rate of vaginal repair (94.8%) at first attempt was comparable to that of abdominal repair (100%) (P value = 0.8946). Amongst two failed vaginal repairs, one was successfully cured by subsequent vaginal repair and other by abdominal repair. Conclusion: Three fourth gynecological supratrigonal VVF can be repaired vaginally in first attempt with success rate comparable to abdominal approach. On the basis of this study we postulate that vaginal approach should be preferred over abdominal approach for repair of all vaginally accessible supratrigonal VVF of gynecological origin.

Rajamaheswari, N.; Chhikara, Archana Bharti; Seethalakshmi, K.; Bail, Anupama; Agarwal, Sugandha

2012-01-01

7

Peritonitis due to a peritoneal vaginal fistula.  

PubMed

Development of a peritoneal vaginal fistula is rare and presents a unique clinical scenario, since the fistula wall is less likely to spontaneously heal because of the increased intra-abdominal pressure in the abdomen from the peritoneal fluid. Catheter removal and surgical repair of the fistula are required. Early catheter removal contributes to peritoneal membrane preservation. In the case of M.T., the most likely explanation was that the peritoneal fluid was leaking through the vaginal cuff created during the surgical procedure in 2004. Early identification of this problem may have prevented the numerous complications and lengthy hospitalization. Suspicion should be raised in any patient who complains of vaginal leakage or if the passage of "urine" in a previously anuric patient is noted. Early assessment and evaluation along with prompt catheter removal can help reduce complications and preserve the peritoneal membrane. This case also emphasizes that prompt catheter removal is very important in cases of fungal peritonitis. PMID:20462078

Neumann, Joanna Lee; Moran, John

8

Humanitarian ventures or ‘fistula tourism?’: the ethical perils of pelvic surgery in the developing world  

Microsoft Academic Search

The vesico-vaginal fistula from prolonged obstructed labor has become a rarity in the industrialized West but still continues to afflict millions of women in impoverished Third World countries. As awareness of this problem has grown more widespread, increasing numbers of American and European surgeons are volunteering to go on short-term medical mission trips to perform fistula repair operations in African

L. Lewis Wall; Steven D. Arrowsmith; Anyetei T. Lassey; Kwabena Danso

2006-01-01

9

Iatrogenic urethrovaginal fistula with transverse vaginal septum presenting as cyclical hematuria  

PubMed Central

We present a case of iatrogenic urethrovaginal fistula with transverse vaginal septum. The patient presented with cyclical hematuria and infertility. The vagina was blind-ending. The magnetic resonance imaging (MRI) showed normal uterus with transverse vaginal septum. The cystoscopic examination during cyclical hematuria revealed bloody efflux through a small fistula below the internal urethral sphincter. Vaginoplasty and repair of the urethrovaginal fistula was done. The vagina was reconstructed using an amniotic mould. The report emphasizes the importance of MRI and cystoscopy in diagnosing such rare and complex anomalies.

Singh, Abha; Kumar, Manisha; Sharma, Sumedha

2011-01-01

10

Simultaneous bladder and vaginal reconstruction using ileum in complicated vesicovaginal fistula  

PubMed Central

Objectives: To discuss the outcome of surgical repair in complicated vesicovaginal fistula with simultaneous bladder and vaginal reconstruction using ileum. Materials and Methods: Four female patients in the age group of 12-30 years are included. All the patients had complicated vesicovaginal fistula with vaginal stenosis secondary to obstetric hysterectomy (except one secondary to the genitourinary tuberculosis). Repair of vesicovaginal fistula with simultaneous bladder augmentation, ureteric reimplantation, and reconstruction of vagina using ileum was performed in all the cases. Results: All the patients had successful repair of fistula. Vaginal reconstruction using ileum, resulted in capacious vagina. Adult patients resumed to normal sexual life. Mucus discharge was the only complaint in postoperative period. Conclusions: Malnutrition, anemia, obstructed labor, Intra uterine fetal death (IUFD), postpartum hemorrhage following forceps delivery in a rural setting followed by an emergency obstetric hysterectomy after a delay of 6-8 h (due to transfer to a tertiary center) were the few contributing factors leading to the formation of vesicovaginal fistula (VVF). Preoperative assessment of bladder capacity and vaginal capacity in such cases is mandatory. The small bowel is a readily available vascular tissue for restoring bladder and vaginal capacity.

Patwardhan, Sujata K.; Sawant, Ajit; Ismail, Mohammad; Nagabhushana, M.; Varma, Radheshyam R.

2008-01-01

11

Vesicovaginal fistula due to vaginal herb for primary infertility: could it be devastating?  

PubMed

Vesicovaginal fistula (VVF) is a very commonly encountered urogynaecological entity in developing countries such as India. The most common cause of VVF in developing counties is secondary to obstructive labour. We report a very unusual case of VVF in a young woman that developed due to insertion of an unknown vaginal herb for treatment of primary infertility. Cystoscopy showed a single trigonal fistula measuring 3×2 cm just near the bladder neck. Vaginoscopy revealed cicatrised less capacious vagina and unhealthy vaginal mucosa. She was treated with transvaginal VVF repair using Martius flap interposition which leaked on 10th postoperative day. She underwent re-evaluation and another transvaginal fistula repair for small trigonal residual fistula after 3 months. She is doing well during the follow-up of 2 years. She attained sexual activity after 3 months of surgical repair but could not conceive. PMID:24092608

Paul, Sagorika; Singh, Vishwajeet; Sinha, Rahul Janak; Kumar, Arvind

2013-10-03

12

Pregnancy in an untreated case of transverse vaginal septum with vesicovaginal fistula.  

PubMed

An 18-year-old woman presented with history of cyclic hematuria, abdominal pain, and a mass in the hypogastrium. She was found to have transverse vaginal septum in the lower one-third of her vagina with congenital vesicovaginal fistula (VVF) and a dead fetus of approximately 20 weeks gestation. She underwent vaginotomy and removal of the dead fetus. Vaginal repair of VVF was carried out 3 months later. PMID:16897124

Srinath, N; Misra, D N

2006-08-09

13

Vaginocutaneous fistula and inguinal abcess presented 6 years after tension-free vaginal tape sling.  

PubMed

Surgical treatment of female stress urinary incontinence (SUI) has become very pop- ular after respectable success with minimal invasive surgeries. This is the first report of long term vaginocutaneous fistula (VCF) plus inguinal abcess after tension-free vaginal tape (TVT). A 67 year-old woman with vaginal discharge lasting more than 3 years complained with a painful swelling in the left inguinal area for the last three months. She had a medical history of TVT sling procedure for SUI six years ago. She had no history of pelvic surgery, cancer treatment or pelvic irradiation before or after TVT sling. No urethrovaginal or vesicovaginal fistula was found in physical examination and cystocopy. MRI showed a vaginocutenaous fistula and inguinal abcess. This case highlights the need for a high index of suspicion for VCF after TVT. PMID:23820661

?ahin, Ali Feyzullah; ?lbey, Yusuf Özlem; ?ahin, Nur

2013-06-24

14

Gluteo-vaginal fistula: a long-term complication of posterior intravaginal slingplasty.  

PubMed

A 67-year-old lady presented to the surgical outpatient clinic with a 4 month history of recurrent purulent discharge from her left buttock. Four years and 4 months prior to this she underwent a posterior intravaginal slingoplasty for vaginal prolapse and urinary stress incontinence. An MRI demonstrated a long gluteo-vaginal fistula tract from the posterior wall of the vaginal vault through the left ischiorectal fossa to the skin. An examination under anaesthesia revealed that the fistulous tract was surrounding the intact mesh used for the posterior intravaginal slingoplasty. The mesh was removed, the fistula tract excised and the perineal wound marsupialised. The patient was discharged 5 days later. The wound healed within 4 weeks and she remains sepsis free 2 years on. PMID:22675111

Sivarajah, Vernon; Bello, Sean O Z; Yiu, Chu Yiu; Oke, Olatokunbo

2011-10-28

15

Vulvar pseudoverrucous papules and nodules secondary to a urethral--vaginal fistula.  

PubMed

Irritant contact dermatitis is a common cause of genital eruptions representing at least one-fifth of presenting anogenital symptoms. A spectrum of inflammatory reactions have been identified, some of them with features severely mimicking more serious dermatoses, which may lead unnecessary workup and treatments. We report a case of a 10-year-old girl who presented at birth with cloacal atresia involving the rectum and the urethra. A diverting colostomy and a urethral-vaginal fistula were created to correct the deformity. Physical examination reveals numerous shiny, white-gray, pseudoverrucous papules and nodules coalescing into plaques over the vulva and its surrounding skin. Histological examination showed psoriasiform epidermal hyperplasia with a marked reactive acanthosis and altered cornification with parakeratosis, hypogranulosis, and pale keratinocytes in the upper reaches of the epidermis. The lesions regress when the irritating factor was removed. This case represents a peculiar form of presentation of perianal pseudoverrucous papules and nodules, usually secondary to urinary incontinence or encopresis (inability to control the elimination of stool) after surgery for Hirschsprung disease. Because similar findings have not been previously observed in patients with urethral-vaginal fistula, we attempt to extend the spectrum of presentations for a better knowledge of this condition. PMID:21285858

Garrido-Ruiz, María Concepción; Rosales, Belen; Luis Rodríguez-Peralto, José

2011-06-01

16

Vesicouterine fistula: An updated review  

Microsoft Academic Search

To ascertain the condition of vesicouterine fistula, a search of the medical literature using the Ovid version (Ovid Technologies Inc., New York, USA) of Medline (1966–1997) was undertaken, using the keywords vesicouterine, vesico-uterine, uterovesico, and utero-vesico fistula. A search of the earlier medical literature was by cross-referencing and is likely to be less complete than the computerized database. Nonetheless, the

Shing-Kai Yip; Tak-Yeung Leung

1998-01-01

17

Vaginitis  

MedlinePLUS

... diagnosed? • How is vaginitis treated? • What is a yeast infection? • What causes yeast infections? • What factors increase the risk of getting a yeast infection? • What are the symptoms of a yeast ...

18

Current status of genitourinary fistula.  

PubMed

From 1970-1985, 303 women with genitourinary fistulas were seen at the Mayo Clinic. The fistula formed after treatment for benign conditions in 74% of the patients and malignant conditions in 14%; in 12%, we were unable to establish the nature of the condition. Gynecologic surgery was responsible for 82% of the fistulas, obstetric procedures for 8%, various forms of irradiation for 6%, and trauma or fulguration for 4%. In the nonirradiated patient, the ideal time for operative repair was eight to 12 weeks after fistula formation or failed repair. With ureterovaginal fistulas, the patient's general condition and the degree of obstruction of the ureter influenced the time and method of repair. We used a vaginal approach for urethral fistulas and an abdominal one for ureteral repairs. Because of difficulty with adequate exposure and the proximity of the ureter, an abdominal approach was used in 20% of the patients with vesicovaginal fistulas; the remaining 80% were approached vaginally, regardless of size, number, or history of previous repairs. Ninety-two percent of the urethrovaginal fistulas were corrected on the first attempt; the four failures were managed successfully at the second attempt. Ninety-eight percent of the vesicovaginal fistulas were corrected on the first attempt when approached vaginally, and all were managed successfully when approached abdominally, regardless of the number, size, or previous operative attempts. PMID:3043287

Lee, R A; Symmonds, R E; Williams, T J

1988-09-01

19

Factors influencing choice of surgical route of repair of genitourinary fistula, and the influence of route of repair on surgical outcomes: findings from a prospective cohort study  

PubMed Central

Objective The abdominal route of genitourinary fistula repair may be associated with longer term hospitalisation, hospital-associated infection and increased resource requirements. We examined: (1) the factors influencing the route of repair; (2) the influence of the route of repair on fistula closure 3 months following surgery; and (3) whether the influence of the route of repair on repair outcome varied by whether or not women met the published indications for abdominal repair. Design Prospective cohort study. Setting Eleven health facilities in sub-Saharan Africa and Asia. Population The 1274 women with genitourinary fistula presenting for surgical repair services. Methods Risk ratios (RRs) and 95% confidence intervals (95% CIs) were generated using log-binomial and Poisson (log-link) regression. Multivariable regression and propensity score matching were employed to adjust for confounding. Main outcome measures Abdominal route of repair and fistula closure at 3 months following fistula repair surgery. Results Published indications for abdominal route of repair (extensive scarring or tissue loss, genital infibulation, ureteric involvement, trigonal, supratrigonal, vesico-uterine or intracervical location or other abdominal pathology) predicted the abdominal route [adjusted risk ratio (ARR), 15.56; 95% CI, 2.12–114.00]. A vaginal route of repair was associated with increased risk of failed closure (ARR, 1.41; 95% CI, 1.05–1.88); stratified analyses suggested elevated risk among women meeting indications for the abdominal route. Conclusions Additional studies powered to test effect modification hypotheses are warranted to confirm whether the abdominal route of repair is beneficial for certain women.

Frajzyngier, V; Ruminjo, J; Asiimwe, F; Barry, TH; Bello, A; Danladi, D; Ganda, SO; Idris, S; Inoussa, M; Lynch, M; Mussell, F; Podder, DC; Barone, MA

2012-01-01

20

Vaginal itching  

MedlinePLUS

... and make you more susceptible to infections. Vaginal yeast infection Vaginitis . Vaginitis in girls before puberty is ... If you are sure that you have a yeast infection, try over-the-counter creams or vaginal ...

21

Vaginal discharge  

MedlinePLUS

... infections and sexually transmitted infections (STIs) Trichomoniasis Vaginal yeast infection ... is never recommended. Use an over-the-counter yeast infection treatment cream or vaginal suppository, if you ...

22

Gender and vesico-ureteral reflux: a multivariate analysis  

Microsoft Academic Search

The aim of this retrospective cohort study was to describe the characteristics of patients with primary vesico-ureteral reflux\\u000a (VUR) with special attention to gender-specific differences. Between 1970 and 2004, 735 patients were diagnosed with VUR and\\u000a were systematically followed in a single tertiary renal unit. The following variables were analyzed: race, age at diagnosis,\\u000a clinical presentation, weight and height Z-score,

Jose Maria Penido Silva; Eduardo Araujo Oliveira; Jose Silverio Santos Diniz; Luis Sergio Bahia Cardoso; Renata Moura Vergara; Mariana Affonso Vasconcelos; Daniela Espirito Santo

2006-01-01

23

Ureteroileal fistulas.  

PubMed

Of the fistulas that involve the urinary and intestinal tracts vesicointestinal fistulas are the most common and nephrointestinal fistulas are infrequent. Ureteroileal fistulas are extremely rare, with only 6 previously reported cases. Three recent cases are presented to highlight current management. In all 3 patients the ureteroileal fistula developed postoperatively, including 1 after radical pelvic surgery for advanced ovarian carcinoma, 1 following failed transureteroureterostomy and 1 after a repeat left ureteral reimplant with a pelvic abscess. Infection and/or urinary leakage had a major role in these cases, similar to the previously reported fistulas. In contrast to the previously reported patients, all of whom underwent surgical excision or revision, the 3 patients described herein were managed successfully with percutaneous nephrostomy or indwelling ureteral stents. Although successful management today may bypass operative intervention in these rare fistulas most are preventable operative complications. PMID:6887377

Nieh, P T

1983-09-01

24

Incontinence and trauma: Sexual violence, female genital cutting and proxy measures of gynecological fistula  

Microsoft Academic Search

Obstetric fistula, characterized by urinary or fecal incontinence via the vagina, has begun to receive attention on the international public health agenda, however less attention has been given to traumatic fistula. Field reports indicate that trauma contributes to the burden of vaginal fistula, especially in regions wrought by civil unrest, however evidence is largely anecdotal or facility-based. This paper specifically

Amber Peterman; Kiersten Johnson

2009-01-01

25

Tandem colovaginoscopy in the diagnosis of colovaginal fistula.  

PubMed

The diagnosis of colovaginal fistula with the traditional methods of contrast enema, sigmoidoscopy, and vaginal speculum examination can be problematic. Precise identification of the pathologic anatomy underlying the colovaginal fistula can be obtained by simultaneous flexible fiberoptic vaginoscopy and colonscopy. PMID:3402289

Adams, D B; Perry, T G

1988-08-01

26

The problem of post-partum fistulas in developing countries  

Microsoft Academic Search

Postpartum fistulas are frequent in the tropical environment. They are mostly found in very young women who live in remote areas. Without treatment women with fistulas will be condemmed to the disconsolate life of social outcasts. Good operative treatment is crucial. The different operative methods are discussed. The operation through vaginal approach can be performed in any hospital. It does

Andreas K. Steiner

1996-01-01

27

Vaginal Yeast Infections  

MedlinePLUS

... HIV/AIDS Sexually transmitted infections fact sheet Vaginal yeast infections fact sheet What is a vaginal yeast ... on vaginal yeast infections What is a vaginal yeast infection? A vaginal yeast infection is irritation of ...

28

[Vesico-renal reflux in adults (author's transl)].  

PubMed

This article is based on an analysis of 88 cases of vesico-renal reflux, 43 primary and 45 secundary ones. The author consider successively the clinical, bacteriological, radiological and endoscopical facts and their relations to the different types of reflux. They emphasize the frequency and the gravity of the primary reflux in adults and its probable connection with the genesis of the non-obstructive pyelonephrities and the unilateral renal atrophies. Its noxioness is primarily connected with the infection. The secundary reflux, however, even infected, is relatively well tolerated in adults. In case of primary vesico-renal reflux the therapeutical conduct has to be extremely well suited. A surgical correction should only be considered if the kidney has satisfactorily maintained its fonction and if the tonicity of the excreting ways is still good enough. In case of secundary reflux, the therapeutical conduct depends first of all on the etiology. In the group of primary reflux 11 patients derived benefit from ureteral reimplantation; whereas in the group of secundary reflux only 5 patients were submitted to an operation. The method applied was that of Paquin. PMID:1206784

Héritier, P; Zingg, E

29

[Utility of diuretic renography in the detection of an enteroureteral fistula].  

PubMed

After a 2-year-old male with left impairment underwent surgery for a left vesicoureteral stenosis, his renal function was followed up by means of dynamic renal scintigraphy with 99mTc-DTPA. Incidental radiotracer accumulation was observed in left hemiabdomen tracing the descending and sigmoid colon. A vesico-colonic fistula was suspected. However, ultrasonography and cystography studies showed no presence of a vesico-enteric fistula. Because the patient persisted without symptoms, an expectant approach was adopted. One year later, he began to suffer watery diarrhoea episodes. 99mTc-DTPA renography was again performed to re-evaluated renal function and explore presence of urinary-enteric fistula. Diuretic renography demonstrated the presence of a vesical leak to sigmoid gut, which was confirmed by recovery of fecal matter from the patient. Both isotopic renograms evidenced the presence of uretero-sigmoid fistula, an uncommon postsurgical that was not detected by cystography, ultrasonography or RMN. The patient subsequently underwent surgery for fistula repair. PMID:17662188

Martínez Gimeno, E; Ramos Font, C; Allende Riera, A; Cárdenas Negro, C; de Sequera Rahola, M; Albalá González, M D; Rodríguez Fernández, A; Uña Gorospe, J A; Antón Hernández, L

30

Vaginal Discharge  

MedlinePLUS

... also be on the lookout for symptoms of yeast infections, bacterial vaginosis and trichomoniasis, 3 infections that ... cause changes in your vaginal discharge. Signs of yeast infections White, cottage cheese-like discharge Swelling and ...

31

Estrogen Vaginal  

MedlinePLUS

... estradiol vaginal ring is also used to treat hot flushes ('hot flashes'; sudden strong feelings of heat and sweating) ... mild soap and warm water. Do not use hot water or boil the applicator. Ask your pharmacist ...

32

Postcoital vaginoperitoneal fistula after hysterectomy for gynecological malignancy  

PubMed Central

A true incidence of postcoital fistula is not known as it is seldom suspected. It presents as acute pneumoperitoneum with signs and symptoms same as that of perforation of a hollow viscus. A 38-year-old parous woman presented with postcoital fistula 10 weeks after panhysterectomy for carcinoma ovary stage IIIc. Pneumoperitoneum was detected, with large amount of gas under the diaphragm on radiograph of the abdomen. A breach was found in the vaginal vault. All other causes of fistula were excluded. Fistula healed spontaneously on follow-up.

Singla, Shilpa; Jain, Sunesh Kumar

2010-01-01

33

Rectocutaneous fistulas.  

PubMed

This article reviews the etiology, diagnosis, and treatment of rectal perforation and rectocutaneous fistula in small animals. In addition, the literature regarding use of enterostomy in small animals is reviewed and comparative aspects of this procedure in humans and horses are presented. A case report of rectal perforation leading to rectocutaneous fistula formation and the use of colostomy in the management of the case is presented. PMID:18576278

Fransson, Boel A

2008-04-01

34

Umbilical cord prolapsed through urethra: An unusual presentation of a vesico-uterine fistula  

PubMed Central

Umbilical cord prolapse occurs when a loop of cord is present below the presenting part when the amniotic membranes are ruptured. The incidence is 0.2% of total births. The case presented here is unusual because the definition of cord prolapse cannot be applied to it and the lady did not complain of any history of urinary incontinence or hematuria. The presentation of umbilical cord through maternal urethra led to the speculation of an opening between the anterior uterine wall and the bladder. Fetal demise was diagnosed by abdominal ultrasound. At laprotomy, a communication was found between the bladder and the uterus thus letting the cord traverse through the bladder.

Kamil, Aneela G.; EL Mekresh, Mohsen

2013-01-01

35

MRI in evaluation of perianal fistulae  

PubMed Central

Background Fistula is considered to be any abnormal passage which connects two epithelial surfaces. Parks’ fistulae classification demonstrates the biggest practical significance and divides fistulae into: intersphincteric, transsphincteric, suprasphincteric and extrasphincteric. Etiology of perianal fistulae is most commonly linked with the inflammation of anal glands in Crohn’s disease, tuberculosis, pelvic infections, pelvic malignant tumours, and with the radiotherapy. Diagnostic method options are: RTG fistulography, CT fistulography and magnetic resonance imaging (MRI) of pelvic organs. Patients and methods We have included 24 patients with perirectal fistulae in the prospective study. X-rays fistulography, CT fistulography, and then MRI of the pelvic cavity have been performed on all patients. Accuracy of each procedure in regards to the patients and the etiologic cause have been statistically determined. Results 29.16% of transphincteric fistulae have been found, followed by 25% of intersphincteric, 25% of recto-vaginal, 12.5% of extrasphincteric, and 8.33% of suprasphincteric. Abscess collections have been found in 16.6% patients. The most frequent etiologic cause of perianal fistulae was Crohn’s disease in 37.5%, where the accuracy of classification of MRI was 100%, CT was 11% and X-rays 0%. Ulcerous colitis was the second cause, with 20.9% where the accuracy of MRI was 100%, while CT was 80% and X-rays was 0%. All other etiologic causes of fistulae were found in 41.6% patients. Conclusions MRI is a reliable diagnostic modality in the classification of perirectal fistulae and can be an excellent diagnostic guide for successful surgical interventions with the aim to reduce the number of recurrences. Its advantage is that fistulae and abscess are visible without the need to apply any contrast medium.

Sofic, Amela; Beslic, Serif; Sehovic, Nedzad; Caluk, Jasmin; Sofic, Damir

2010-01-01

36

Vaginal Cancer  

MedlinePLUS

... Vaginal cancer treatments are likely to cause side effects that make sexual intimacy more difficult for you and your partner. If treatment makes sex painful or temporarily impossible, try to find new ways of maintaining intimacy. Spending quality time together and having ...

37

Vaginal Cancer  

MedlinePLUS

... body). There are four types of vaginal cancer: Squamous cell carcinoma. Squamous cell carcinoma is a type of skin cancer that begins in the cells lining the vagina, most often in the area closest to the cervix. Squamous cell cancer makes up 85% to 90% of ...

38

Endourologic diagnosis and treatment of ureterouterine fistula  

Microsoft Academic Search

A rare case of ureterouterine fistula following a dilatation and evacuation for elective abortion is presented. According\\u000a to the literature, most cases are related to elective abortion. A 42-year-old woman, 1-0-5-1, presented with copious watery\\u000a vaginal discharge from the cervical os. She had had an elective abortion followed by a laparotomy for a suspected uterine\\u000a perforation with peritonitis 1 months

A. C. Wang; C. F. Hung

1997-01-01

39

Colouterine fistula complicating diverticulitis diagnosed at hysteroscopy: case report.  

PubMed

Since Noecker first reported a colouterine fistula secondary to diverticulitis in 1929, about 20 cases have been reported in the literature. Methods for diagnosis have yet to be established. Herein we report the first case of a colouterine fistula at the level of the isthmus diagnosed at hysteroscopy. Diagnostic hysteroscopy enabled rapid diagnosis of the colouterine fistula. Diagnostic hysteroscopy is the first-choice diagnostic tool for investigation of any abnormal vaginal discharge such as blood or stool because it enables direct vision and biopsy of the lesions of the lower genital tract quickly and at low cost. PMID:22196260

Mandato, Vincenzo Dario; Abrate, Martino; Sandonà, Francesco; Costagliola, Luigi; Gastaldi, Alfredo; La Sala, Giovanni Battista

40

Vaginal agenesis.  

PubMed

Vaginal agenesis is not rare. Many ingenious procedures have been devised for its correction; some are simple, and some are complicated. Not enough emphasis has been placed on the emotional aspects when patients with this problem are treated. Proper timing of the operation and selection of the best procedure are discussed. We feel that procedure of choice is the simplest, least dangerous one which will give good results in the individual patient. Rather than using the same routine procedure in each patient, we fitted the treatment to each patient. Our experience, particularly with the simple vulvovaginoplasty technique, is given. Postoperative support and encouragement are needed to have a successful outcome. PMID:1244753

Capraro, V J; Gallego, M B

1976-01-01

41

Retained pill camera at an entero-uracho-vesical fistula site in a patient with Crohn's disease.  

PubMed

An 18-year-old female patient with Crohn's disease had abdominal pain secondary to a retained pill camera. After several weeks of medical management, the camera spontaneously passed. However, the patient also had an intra-abdominal abscess that worsened, despite medical therapy. Surgical therapy was recommended and a 5cm infected urachal cyst with entero-urachal and vesico-urachal fistulas was discovered. An en-bloc resection of the entire area was performed to include the urachal cyst, the adherent portion of the dome of the bladder, and 15cm of associated ileum. The bladder was repaired, a suprapubic catheter was placed, and an ileo-ileal anastamosis was performed. Microscopic findings were consistent with active Crohn's disease and fistula formation. The entero-uracho-vesical fistula site was likely the site of the retained pill camera. The patient did well postoperatively and was discharged on postoperative day six without complications. PMID:23795327

Yheulon, Christopher G; Derosa, Daniel C; Gagliano, Ronald A

2013-06-01

42

Retained Pill Camera at an Entero-Uracho-Vesical Fistula Site in a Patient with Crohn's Disease  

PubMed Central

An 18-year-old female patient with Crohn's disease had abdominal pain secondary to a retained pill camera. After several weeks of medical management, the camera spontaneously passed. However, the patient also had an intra-abdominal abscess that worsened, despite medical therapy. Surgical therapy was recommended and a 5cm infected urachal cyst with entero-urachal and vesico-urachal fistulas was discovered. An en-bloc resection of the entire area was performed to include the urachal cyst, the adherent portion of the dome of the bladder, and 15cm of associated ileum. The bladder was repaired, a suprapubic catheter was placed, and an ileo-ileal anastamosis was performed. Microscopic findings were consistent with active Crohn's disease and fistula formation. The entero-uracho-vesical fistula site was likely the site of the retained pill camera. The patient did well postoperatively and was discharged on postoperative day six without complications.

Derosa, Daniel C; Gagliano, Ronald A

2013-01-01

43

Predictors and outcome of surgical repair of obstetric fistula at a regional referral hospital, Mbarara, western Uganda  

PubMed Central

Background Obstetric fistula although virtually eliminated in high income countries, still remains a prevalent and debilitating condition in many parts of the developing world. It occurs in areas where access to care at childbirth is limited, or of poor quality and where few hospitals offer the necessary corrective surgery. Methods This was a prospective observational study where all women who attended Mbarara Regional Referral Hospital in western Uganda with obstetric fistula during the study period were assessed pre-operatively for social demographics, fistula characteristics, classification and outcomes after surgery. Assessment for fistula closure and stress incontinence after surgery was done using a dye test before discharge Results Of the 77 women who were recruited in this study, 60 (77.9%) had successful closure of their fistulae. Unsuccessful fistula closure was significantly associated with large fistula size (Odds Ratio 6 95% Confidential interval 1.46-24.63), circumferential fistulae (Odds ratio 9.33 95% Confidential interval 2.23-39.12) and moderate to severe vaginal scarring (Odds ratio 12.24 95% Confidential interval 1.52-98.30). Vaginal scarring was the only factor independently associated with unsuccessful fistula repair (Odds ratio 10 95% confidential interval 1.12-100.57). Residual stress incontinence after successful fistula closure was associated with type IIb fistulae (Odds ratio 5.56 95% Confidential interval 1.34-23.02), circumferential fistulae (Odds ratio 10.5 95% Confidential interval 1.39-79.13) and previous unsuccessful fistula repair (Odds ratio 4.8 95% Confidential interval 1.27-18.11). Independent predictors for residual stress incontinence after successful fistula closure were urethral involvement (Odds Ratio 4.024 95% Confidential interval 2.77-5.83) and previous unsuccessful fistula repair (Odds ratio 38.69 95% Confidential interval 2.13-703.88). Conclusions This study demonstrated that large fistula size, circumferential fistulae and marked vaginal scarring are predictors for unsuccessful fistula repair while predictors for residual stress incontinence after successful fistula closure were urethral involvement, circumferential fistulae and previous unsuccessful fistula repair.

2011-01-01

44

The epidemiology of genitourinary fistulae in Kumasi, Ghana, 1977-1992.  

PubMed

The aim of the study was to determine the clinical epidemiology of genitourinary fistulae as seen at Komfo Anokye Teaching Hospital in Kumasi, Ghana. A retrospective study was carried out from the hospital records and operative reports of all patients with genitourinary fistulae seen at Komfo Anokye Teaching Hospital between January 1977 and December 1992. Patient age, parity, type of fistula and cause of fistula were abstracted from the medical records. There were 164 cases of genitourinary fistula managed during the study period. There were 150 fistulae due to obstetric causes (91, 5%), the vast majority of which were due to prolonged obstructed labor (121 cases, 73.8% of all fistulae), with a minority related to complications of lower-segment cesarean section (14 cases, 8.5% of all fistulae). In 5 cases (3.1%) patients developed a rectovaginal fistula owing to perineal tears and prolonged obstructed labor. During this time period there were 157,449 deliveries, giving an obstetric fistula rate of 1 fistula per 1000 deliveries. Obstetric fistulae were most common at the extremes of reproductive age and parity Fourteen additional fistulae (8.5% of all cases) were due to gynecologic causes, most commonly from surgical injury occurring at the time of abdominal hysterectomy for leiomyomata uteri (12 cases, 7.3% of all fistulae). It was concluded that in Kumasi, Ghana, obstetric trauma from prolonged obstructed labor is the most common cause of genitourinary fistula formation. Such fistulae occur in older multiparous women as well in young primigravidae. Obstructed labour can, and does, occur in women who have previously undergone uneventful vaginal delivery. Birth attendants should be aware of that fact. Prompt referral for obstetric intervention should be made in obstructed labor, irrespective of the age and parity of the patient. PMID:8913827

Danso, K A; Martey, J O; Wall, L L; Elkins, T E

1996-01-01

45

Colouterine Fistula Caused by Diverticulitis of the Sigmoid Colon  

PubMed Central

Colouterine fistula is an extremely rare condition because the uterus is a thick, muscular organ. Here, we present a case of a colouterine fistula secondary to colonic diverticulitis. An 81-year-old woman was referred to the emergency department with abdominal pain and vaginal discharge. Computed tomography showed a myometrial abscess cavity in the uterus adherent to the thick sigmoid wall. Upon contrast injection via the cervical os for fistulography, we observed spillage of the contrast into the sigmoid colon via the uterine fundus. Inflammatory adhesion of the distal sigmoid colon to the posterior wall of the uterus was found during surgery. The colon was dissected off the uterus. Resection of the sigmoid colon, primary anastomosis, and repair of the fistula tract of the uterus were performed. The postoperative course was uneventful. This case represents an unusual type of diverticulitis complication and illustrates diagnostic procedures and surgical management for a colouterine fistula.

2012-01-01

46

Incomplete protection mechanism against vesico-ureteral reflux and hydronephrosis in the inbred mouse strain DDD  

Microsoft Academic Search

Summary We have previously reported the occurrence and inheritance mode of hydronephrosis in the inbred mouse strain DOD. The present investigation examined the possibility that hydronephrosis may be caused by a vesico-ureteral reflux (VUR). Bladder pressure was measured under anaesthesia in 3 strains of mice (DOD, ddY and C57BL\\/6). VUR was demonstrated by lower bladder pressure only in the ODD

H. Mannen; S. Tsuji; N. Goto

1991-01-01

47

Cholecystogastric fistula: laparoscopic repair.  

PubMed

We describe a patient with a cholecystogastric fistula treated by the laparoscopic approach. The use of intracorporeal suturing allows laparoscopic management of cholecystogastric fistulae without the need for an endoscopic transecting stapler. PMID:11525375

Prasad, A; Kapur, R

2001-08-01

48

[Bacterial vaginitis: general overview].  

PubMed

Bacteria are the most frequently detected agents in women, clinically complaining of vaginal discharge. The studies have shown that the vaginal microflora of women with bacterial vaginitis have altered from Lactobacillus spp. to various anaerobic bacteria. Gardnerella vaginalis is found in vaginal flora of women with bacterial vaginitis as well as in healthy women, while anaerobic bacteria such as Mobiluncus and Prevotella are the causative agents for bacterial vaginosis. For the laboratory diagnosis of bacterial vaginitis, direct microscopy is one of the most commonly used methods, and for this purpose cervicovaginal smears are examined by staining Papanicolaou and Gram stains. Because of the demonstration of bacterial vaginitis in association with the obstetric diseases such as preterm labor and postpartum endometritis, is a risk factor, its importance has increased recently. In this review article, the microorganisms that cause bacterial vaginitis, their biological characteristics, and the diagnostic laboratory methods of infection, have been discussed. PMID:12838684

Demirezen, Sayeste

2003-01-01

49

What Is Vaginal Cancer?  

MedlinePLUS

... cancer There are several types of vaginal cancer. Squamous cell carcinoma About 70 of every 100 cases of vaginal cancer are squamous cell carcinomas . These cancers begin in the squamous cells that ...

50

Obstetric Fistula in Mali  

Microsoft Academic Search

Obstetric fistula is arguably the most devastating result of childbirth complications, aside from maternal and neonatal mortality, the latter of which almost always occurs during deliveries which result in fistula. Defined as a hole in the birth canal, obstetric fistula is generally caused by prolonged obstructed labor in the absence of prompt medical intervention.20 This injury results in chronic incontinence

Chandler O’Connell

2008-01-01

51

Octreotide and Gastrointestinal Fistulae  

Microsoft Academic Search

The place of somatostatin and its analogues in the management of gastrointestinal fistulae is reviewed, drawing attention to the difficulty of assessing treatments that influence spontaneous closure. Sixteen patients with gastric, small bowel, and pancreatic fistulae were randomized to receive octreotide injections (100 ?g t.i.d.) or placebo for 12 days. Spontaneous fistula closure occurred in 7 at a mean of

N. A. Scott; S. Finnegan; M. H. Irving

1990-01-01

52

Esophageal Atresia and Tracheoesophageal Fistula  

MedlinePLUS

MENU Return to Web version Esophageal Atresia and Tracheoesophageal Fistula Overview What is esophageal atresia? In babies who ... swallows gets into the stomach. What is a tracheoesophageal fistula? A fistula (say “fist-you-lah”) is a ...

53

Early management and long-term outcomes in primary vesico-ureteric reflux.  

PubMed

What's known on the subject? and What does the study add? Despite evolving understanding of pathogenesis and natural history, controversy exists regarding management of childhood vesicoureteric reflux. Surgical correction of the reflux itself may reduce risk of upper tract complications in some but may not in itself constitute appropriate management of lower tract morbidity in many. This review examines the evidence for early management and long term outcomes in primary vesicoureteric reflux. Primary vesico-ureteric reflux is a common condition in childhood associated with bladder dysfunction and an increased risk of urinary tract infection. Recent evidence indicates a lower tract functional abnormality in its pathogenesis. Whilst spontaneous resolution will occur in many, some patients will go on to develop complications in adulthood including reflux nephropathy, hypertension, urinary tract infection, bladder dysfunction and complications of pregnancy. An evolving understanding of the natural history has seen radical changes in management. Evidence for management of the child with primary vesico-ureteric reflux is reviewed with a focus on the implications on long-term outcomes in adulthood. PMID:22085118

Coleman, Robert

2011-11-01

54

Vaginal mechanical contraceptive devices.  

PubMed Central

The alleged adverse effects of oral contraceptives and intrauterine devices have led to increased consumer and physician demand for vaginal contraceptive devices. The efficacy and the advantages and disadvantages of vaginal sponges, cervical caps and diaphragms are discussed and compared in this article.

Smith, M.; Barwin, B. N.

1983-01-01

55

[Imaging of dialysis fistulae].  

PubMed

Vascular access malfunctions can be diagnosed by means of imaging and non-imaging methods. The former are: ultrasound (US), colour Doppler ultrasonography, arteriography and phlebography. Radiological imaging allows for direct assessment of the morphology and function of the hemodialysis fistula, and shows precisely the kind and location of lesions, that may lead to access failure. The aim of the study was to present the algorithm of methods employed in evaluation of hemodialysis fistulae, that had been developed by the authors. From March 1995 to July 2001, 1020 colour Doppler ultrasonography examinations were performed, followed by 250 angiographies of hemodialysis fistulae. In the studied group there were 170 well functioning hemo-dialysis fistulae. They were evaluated in order to establish normal blood flow parameters in the fistula. In 135 patients with symptoms of fistula failure US revealed the presence of pathological lesions, such as thrombosis or aneurysm of the venous branch. In 193 cases the presence of stenosis was stated. Three hundred eleven hemodialysis fistulae were sonographically evaluated before the patient was referred to surgical (81) or intravascular (230) treatment. Post-operative assessment was performed in 125 cases. In 231 cases, angiography confirmed the results of US. In 19 cases the degree of fistula stenosis was underestimated in colour Doppler sonography. Colour Doppler sonography is a method of choice in evaluation of arteriovenous hemodialysis fistulae. Abnormal results of physical examinations, dialysis parameters, as well as patients complaints associated with the fistula are indications to perform an ultrasound examination. Angiography is required in case of dubious US findings or as the first step in endovascular treatment. PMID:15792025

Pietura, Rados?aw; Szyma?ska, Anna; Krzyzanowski, Wojciech; Szczerbo-Trojanowska, Ma?gorzata

2004-01-01

56

[Vaginitis and vaginosis].  

PubMed

Recently, within the wide subject on vaginal phlogosis a new pathology has been included. Owing to its peculiar characteristics, as it is not to be regarded as a vaginitis in the strict sense of the word, it has been identified as anaerobic bacterial vaginosis. The latter proves to be different from most common vaginitis related pathologies as a result of a series of microbiological and clinical patterns that are widely dealt with in this research. Moreover, the author place special emphasis on the diagnostic and therapeutic aspects of vaginosis. PMID:2284037

Cerza, S; Cerza, G; Custo, G M

1990-09-01

57

Vesicovaginal fistula: An update  

PubMed Central

Vesicovaginal fistula (VVF) has been a social and a surgical problem for centuries and remains a challenge to surgeons. Though advances have been made in the understanding of the etiology, diagnostic procedures and management of these fistulae, controversies still exist over the ideal approach and time to repair. This review was undertaken to look into the recent literature with regard to the timing and surgical approach to VVF repair. The literature search was done using the Medline database with keywords: vesicovaginal fistula, laparoscopy and robotic repair filtered for the last 5 years.

Kumar, Santosh; Kekre, Nitin S.; Gopalakrishnan, Ganesh

2007-01-01

58

Review of Vaginitis  

PubMed Central

Adisruption of the dynamic equilibrium of the healthy vagina may have significant sequelae, leading to chronic or serious conditions. Therefore, all cases of vaginitis should be accurately diagnosed and appropriately treated.

1993-01-01

59

Yeast Infection (Vaginal)  

MedlinePLUS

... may be reprinted for personal, noncommercial use only. Yeast infection (vaginal) By Mayo Clinic staff Original Article: http://www.mayoclinic.com/health/yeast-infection/DS01182 Definition Symptoms Causes Risk factors Preparing ...

60

Vaginitis - self-care  

MedlinePLUS

... of all ages. It can be caused by: Yeast, bacteria, viruses, and parasites Bubble baths, soaps, vaginal ... Creams or suppositories are used to treat yeast infections in the ... some grocery stores, and other stores. Treating yourself ...

61

Comparative Assessment of Pelvic Floor Function Using Vaginal Cones, Vaginal Digital Palpation and Vaginal Pressure Measurements  

Microsoft Academic Search

A group-comparative study to assess pelvic floor muscle function using vaginal cones, vaginal digital palpation, and vaginal pressure measurements in 30 women suffering from genuine stress urinary incontinence and in an age-matched group of continent women was undertaken. Vaginal digital palpation score and vaginal pressure during active contraction were greater (p < 0.001) in continent women (1.9 ± 0.1 and

Inger Hahn; Ian Milsom; Bo L. Ohlssor; Peter Ekelund; Christer Uhlemann; Magnus Fall

1996-01-01

62

Spontaneous Healing of a Rectovaginal Fistula Developing after Laparoscopic Segmental Bowel Resection for Intestinal Deep Infiltrating Endometriosis  

PubMed Central

The surgical treatment of intestinal deep infiltrating endometriosis has an associated risk of major complications such as dehiscence of the intestinal anastomosis, pelvic abscess, and rectovaginal fistula. The management of postoperative rectovaginal fistula frequently requires a reoperation and the construction of a stoma for temporary fecal diversion. In this paper we describe a 27-year-old woman undergoing laparoscopic treatment of deep infiltrating endometriosis (extramucosal cystectomy, resection of the uterosacral ligaments, resection of the posterior vaginal fornix, and segmental bowel resection) complicated by a rectovaginal fistula, which healed spontaneously with nonsurgical conservative treatment.

Trippia, Carlos Henrique; Zomer, Monica Tessmann

2013-01-01

63

Spontaneous healing of a rectovaginal fistula developing after laparoscopic segmental bowel resection for intestinal deep infiltrating endometriosis.  

PubMed

The surgical treatment of intestinal deep infiltrating endometriosis has an associated risk of major complications such as dehiscence of the intestinal anastomosis, pelvic abscess, and rectovaginal fistula. The management of postoperative rectovaginal fistula frequently requires a reoperation and the construction of a stoma for temporary fecal diversion. In this paper we describe a 27-year-old woman undergoing laparoscopic treatment of deep infiltrating endometriosis (extramucosal cystectomy, resection of the uterosacral ligaments, resection of the posterior vaginal fornix, and segmental bowel resection) complicated by a rectovaginal fistula, which healed spontaneously with nonsurgical conservative treatment. PMID:23710392

Kondo, William; Ribeiro, Reitan; Trippia, Carlos Henrique; Zomer, Monica Tessmann

2013-04-27

64

Value of vaginal culture in management of acute vaginitis  

Microsoft Academic Search

Objective: To evaluate the relative contribution of clinical assessment and vaginal discharge cultures in the treatment of acute vaginitis.\\u000a Methods: A prospective observational study of 75 consecutive sexually active women with acute vaginal symptoms was undertaken. Each\\u000a patient underwent an evaluation that included a standardized history, interview a thorough pelvic examination and vaginal\\u000a culture. The treatment was administered based upon

S. Lurie; I. Woliovitch; S. Rotmensch; O. Sadan; M. Glezerman

2001-01-01

65

Management of vaginal agenesis.  

PubMed

Rokitansky syndrome and complete androgen insensitivity syndrome are the most common causes of vaginal agenesis. Treatment should be deferred until adolescence to allow informed consent and compliance. The best treatment for vaginal agenesis remains controversial although vaginal dilation therapy is still widely considered the first line treatment because success rates are high and associated risks are low. A variety of surgical options are also available, each with enthusiastic proponents. Long-term outcome studies on most surgical techniques, however, are still lacking and until recently most studies have reported on success rate in terms of anatomical success only, without including sexual function. Moreover, the medical literature lacks prospective comparative outcome studies, meaning that current choice of surgical procedure relies greatly on the surgeon's preference and experience. PMID:21872517

Nakhal, Rola S; Creighton, Sarah M

2011-08-27

66

Arteriovenous Fistula of the Breast  

Microsoft Academic Search

Arteriovenous fistulae (AVF) are the result of communication occurring between an artery andan adjacent vein. The etiology of an arterio-venous fistula can be either acquired or congenital in nature. They may occur anywhere in the body where arteries and veins are in proximity to each other. This case report involves an iatrogenic arteriovenous fistula discovered by sonographic examination in a

Michelle Rhodes-Wilson

2004-01-01

67

Vaginal polyp in a newborn.  

PubMed

Vaginal fibroepithelial polyp is a rare lesion, and although benign, it can be confused with malignant connective tissue lesions. Treatment is simple excision, and recurrence is extremely uncommon. We report a case of a newborn with vaginal fibroepithelial polyp. The authors suggest that vaginal polyp must be considered in the evaluation of interlabial masses in prepubertal girls. PMID:17619202

Jallouli, Mohamed; Trigui, Lilia; Gargouri, Abdellatif; Mhiri, Riadh

2007-07-07

68

Round window fistula.  

PubMed

Round window fistula as a cause of sudden hearing loss was diagnosed in five people. It was associated with a sudden change in middle ear pressure in three, with heavy lifing in one, and was probably caused by a significant blast exposure in the other. The clinical features of the condition are varied, with hearing loss and tinnitus being the only constant findings in our patients. One case demonstrates, perhaps for the first time, the association of an abnormally mobile portion of the round window membrane with vertigo and nystagmus. Suggestions on identification and management of round window fistula are made. PMID:994277

Nedzelski, J M; Barber, H O

1976-10-01

69

Vulvar and vaginal HPV disease.  

PubMed

Human papilloma virus is associated with a multitude of lower genital tract diseases in women in addition to cervical cancer, including genital warts, vulvar intraepithelial neoplasia, vaginal intraepithelial neoplasia, and some vulvar, vaginal, and anal cancers that are associated with oncogenic subtypes. The degree to which HPV manifests pathology depends on viral type, host immune response, and local environmental factors. This article reviews the evaluation and management of the following vulvar and vaginal human papilloma virus diseases: condyloma, vulvar intraepithelial neoplasia, and vaginal intraepithelial neoplasia. Included is a brief discussion of the association with vulvar and vaginal cancer. PMID:23732036

Nelson, Erin L; Stockdale, Colleen K

2013-06-01

70

Rectocutaneous fistula: a rare complication of the posterior intravaginal sling.  

PubMed

The posterior intravaginal sling (IVS) is a device used to correct apical vaginal prolapse; there are limited data on associated complications. We present a case report of a rectocutaneous fistula forming after placement of a posterior IVS in a 59-year-old woman 2 months postoperatively. The sling was resected during sigmoidoscopy with scissors, and the colon laceration was closed. The buttock wound underwent delayed healing 2 weeks later. More data regarding complications associated with use of this device are needed before widespread use. PMID:17928934

Yee, Yoke-Hong; Lu, Chien-Chang; Kung, Fu-Tsai; Huang, Kuan-Hui

2007-10-10

71

Failed Operative Vaginal Delivery  

PubMed Central

Objective To compare maternal and neonatal outcomes in women undergoing a second stage cesarean after a trial of operative vaginal delivery with women undergoing a second stage cesarean without such an attempt. Methods This study is a secondary analysis of the women who underwent second stage cesarean. .The maternal outcomes examined included blood transfusion, endometritis, wound complication, anesthesia use, and maternal death. Infant outcomes examined included umbilical artery pH < 7.0, Apgar of 3 or less at 5 minutes, seizures within 24 hours of birth, hypoxic ischemic encephalopathy (HIE), stillbirth, skull fracture, and neonatal death. Results Of 3189 women who underwent second stage cesarean, operative vaginal delivery was attempted in 640. Labor characteristics were similar in the two groups with the exception of the admission to delivery time and cesarean indication. Those with an attempted operative vaginal delivery were more likely to undergo cesarean delivery for a non-reassuring fetal heart rate tracing (18.0% vs 13.9%, p=.01), have a wound complication (2.7% vs 1.0%; OR 2.65 95% CI 1.43–4.91), and require general anesthesia (8.0% vs 4.1%, OR 2.05 95% CI 1.44–2.91). Neonatal outcomes including umbilical artery pH less than 7.0, Apgar at or below 3 at 5 minutes, and hypoxic ischemic encephalopathy were more common for those with an attempted operative vaginal delivery. This was not significant when cases with a non-reassuring fetal heart rate tracing were removed. Conclusion Cesarean delivery after an attempt at operative vaginal delivery was not associated with adverse neonatal outcomes in the absence of a non-reassuring fetal heart rate tracing.

Alexander, James M.; Leveno, Kenneth J.; Hauth, John C.; Landon, Mark B.; Gilbert, Sharon; Spong, Catherine Y.; Varner, Michael W.; Caritis, Steve N.; Meis, Paul; Wapner, Ronald J.; Sorokin, Yoram; Miodovnik, Menachem; O'Sullivan, Mary J.; Sibai, Baha M.; Langer, Oded; Gabbe, Steven G.

2010-01-01

72

Vesico ureteric reflux and renal scarring in children with urinary tract infection.  

PubMed

To evaluate the presence of vesico ureteric reflux (VUR) and renal scarring in children with documented symptomatic urinary tract infection (UTI), and the importance of age at time of presentation, we studied 29 patients with UTI. Nineteen patients were females and 10 were males. Three patients were below one year of age, 13 were between one and five years, and 13 were above five years. None of the patients had systemic hypertension or renal insufficiency. All patients had renal ultrasound and renal scintigraphy with dimercapto succinic acid (DMSA). Micturating cystourethrogram was done in all children below age of five, and in patients above age of five if renal scintigraphy showed evidence of scarring. Of the 29 UTI patients 10 (34%) had VUR. Of the patients with VUR, seven were below age of five while three were above five. Renal scarring was found in 3/7 patients with VUR below age of five years, but was in all patients with VUR above age of five years. All patients with grade 3 and 4 reflux nephropathy had renal scarring, while it was found in half of the patients with grade 1 and 2 reflux. We conclude that in UTI patients VUR is not uncommon finding, which needs further investigations and follow-up. PMID:18417912

Hazza, I; Wahadeneh, A; Qudah, E; Ahmad, M

73

Anorectal Infection: Abscess-Fistula  

PubMed Central

Anorectal abscess and fistula are among the most common diseases encountered in adults. Abscess and fistula should be considered the acute and chronic phase of the same anorectal infection. Abscesses are thought to begin as an infection in the anal glands spreading into adjacent spaces and resulting in fistulas in ~40% of cases. The treatment of an anorectal abscess is early, adequate, dependent drainage. The treatment of a fistula, although surgical in all cases, is more complex due to the possibility of fecal incontinence as a result of sphincterotomy. Primary fistulotomy and cutting setons have the same incidence of fecal incontinence depending on the complexity of the fistula. So even though the aim of a surgical procedure is to cure a fistula, conservative management short of major sphincterotomy is warranted to preserve fecal incontinence. However, trading radical surgery for conservative (nonsphincter cutting) procedures such as a draining seton, fibrin sealant, anal fistula plug, endorectal advancement flap, dermal island flap, anoplasty, and LIFT (ligation of intersphincteric fistula tract) procedure all result in more recurrence/persistence requiring repeated operations in many cases. A surgeon dealing with fistulas on a regular basis must tailor various operations to the needs of the patient depending on the complexity of the fistula encountered.

Abcarian, Herand

2011-01-01

74

Vaginal leiomyoma in pregnancy presenting as a prolapsed vaginal mass.  

PubMed

Vaginal leiomyomas are rare benign solid tumours of the vagina. They can cause mechanical dystocia, which is a common problem in obstetrics leading to serious maternal and perinatal complications. Here we describe a patient with a vaginal leiomyoma diagnosed during the mid-trimester that could have caused dystocia. This 22-year-old woman presented with a vaginal mass and leaking vaginal fluid during pregnancy. On examination, a prolapsed, pedunculated mass, measuring 5 × 3 × 4 cm was detected in the anterior vaginal wall. Via a midline incision, the mass was easily enucleated and removed. Transvaginal surgical enucleation of the vaginal leiomyoma is usually curative and recommended as the initial treatment of choice to prevent for dystocia. Such treatment is indicated when the tumour is a potential obstacle to normal labour. PMID:23223657

Dane, Cem; Rustemoglu, Yaprak; Kiray, Murat; Ozkuvanci, Unsal; Tatar, Zeynep; Dane, Banu

2012-12-01

75

Percutaneous transvenous balloon occlusion of arteriovenous fistula  

Microsoft Academic Search

The closure of arteriovenous fistulas, using a balloon catheter introduced through the vein draining the fistula, is discussed. The application of this method to the closure of an iatrogenic vertebrovertebral fistula is described.

B. Kendall; R. Hoare

1980-01-01

76

Abnormal vaginal bleeding in the nonpregnant patient  

Microsoft Academic Search

Abnormal vaginal bleeding is a common presenting complaint to most emergency departments. This article focuses on vaginal bleeding in the nonpregnant patient; pregnancy-related vaginal bleeding is reviewed elsewhere in this issue. Vaginal bleeding can be the cause of significant morbidity and mortality in nonpregnant patients. Vaginal bleeding can also herald serious underlying problems related to malignancy, chronic illness, and sexual

Richard V. Daniels; Charles McCuskey

77

Surgical Management of Enterocutaneous Fistula  

PubMed Central

Enterocutaneous (EC) fistula is an abnormal connection between the gastrointestinal (GI) tract and skin. The majority of EC fistulas result from surgery. About one third of fistulas close spontaneously with medical treatment and radiologic interventions. Surgical treatment should be reserved for use after sufficient time has passed from the previous laparotomy to allow lysis of the fibrous adhesion using full nutritional and medical treatment and until a complete understanding of the anatomy of the fistula has been achieved. The successful management of GI fistula requires a multi-disciplinary team approach including a gastroenterologist, interventional radiologist, enterostomal therapist, dietician, social worker and surgeons. With this coordinated approach, EC fistula can be controlled with acceptable morbidity and mortality.

2012-01-01

78

Cutting seton for anal fistulas  

Microsoft Academic Search

PURPOSE: Long-term results of cutting seton in the treatment of anal fistulas were studied. METHODS: Of the 44 patients with anal fistulas, mainly of the high variety, managed with this method, 35 (25 men) attended a clinical and manometric follow-up examination on average 70 (range, 28–184) months after operation. Fistula distribution was high transsphincteric (25), low transsphincteric (5), extrasphincteric (3),

Kari-Pekka J. HÄmÄlÄinen; A. Peter Sainio

1997-01-01

79

Genes in the Ureteric Budding Pathway: Association Study on Vesico-Ureteral Reflux Patients  

PubMed Central

Vesico-ureteral reflux (VUR) is the retrograde passage of urine from the bladder to the urinary tract and causes 8.5% of end-stage renal disease in children. It is a complex genetic developmental disorder, in which ectopic embryonal ureteric budding is implicated in the pathogenesis. VUR is part of the spectrum of Congenital Anomalies of the Kidney and Urinary Tract (CAKUT). We performed an extensive association study for primary VUR using a two-stage, case-control design, investigating 44 candidate genes in the ureteric budding pathway in 409 Dutch VUR patients. The 44 genes were selected from the literature and a set of 567 single nucleotide polymorphisms (SNPs) capturing their genetic variation was genotyped in 207 cases and 554 controls. The 14 SNPs with p<0.005 were included in a follow-up study in 202 cases and 892 controls. Of the total cohort, ?50% showed a clear-cut primary VUR phenotype and ?25% had both a duplex collecting system and VUR. We also looked for association in these two extreme phenotype groups. None of the SNPs reached a significant p-value. Common genetic variants in four genes (GREM1, EYA1, ROBO2 and UPK3A) show a trend towards association with the development of primary VUR (GREM1, EYA1, ROBO2) or duplex collecting system (EYA1 and UPK3A). SNPs in three genes (TGFB1, GNB3 and VEGFA) have been shown to be associated with VUR in other populations. Only the result of rs1800469 in TGFB1 hinted at association in our study. This is the first extensive study of common variants in the genes of the ureteric budding pathway and the genetic susceptibility to primary VUR.

van Eerde, Albertien M.; de Kovel, Carolien G. F.; Koeleman, Bobby P. C.; Knoers, Nine V. A. M.; Renkema, Kirsten Y.; van der Horst, Henricus J. R.; Bokenkamp, Arend; van Hagen, Johanna M.; van den Berg, Leonard H.; Wolffenbuttel, Katja P.; van den Hoek, Joop; Feitz, Wouter F.; de Jong, Tom P. V. M.; Giltay, Jacques C.; Wijmenga, Cisca

2012-01-01

80

Secondary aortoduodenal fistula.  

PubMed

Secondary aortoenteric fistula (SAF) is now recognized as an uncommon but exceedingly important complication of abdominal aortic reconstruction. The complication often occurs months to years after the original surgery. The main clinical manifestation of the disease is always upper gastrointestinal bleeding. Treatment of the disease is early surgical intervention. The mortality is high if no prompt operation. We present a case of secondary aortoduodenal fistula (SADF) found 20 days after aortic reconstructive surgery, with the clinical presentation of upper gastrointestinal bleeding. Even immediate exploratory laparotomy was performed, the patient died 48 hrs after the surgical management. Because of the increasing number of elective aortic aneurysm repairs in the aging population, it is likely that more patients with SAF will present to the clinical physicians in the future. So, a high index of suspicion is necessary for prompt diagnosis and treatment of this actually life-threatening event. PMID:12479626

Chang, Meng-Wei; Chan, Yi-Ling; Hsieh, Hung-Chang; Chang, Shy-Shin

2002-09-01

81

Iatrogenic femoral arteriovenous fistula  

Microsoft Academic Search

Twelve iatrogenic femoral arteriovenous fistulas are reported, 11 of which arose from the superficial or deep femoral arteries.\\u000a All but two occurred in association with cardiac angiographic procedures. It appears that the femoral crease was used as a\\u000a landmark to establish the cutaneous entry point for vascular puncture and resulted in an excessively distal puncture site.\\u000a The femoral crease is

Richard E. Marsan; Virginia McDonald; Subramanian Ramamurthy

1990-01-01

82

Bronchobiliary fistula: an anesthetic challenge!  

Microsoft Academic Search

A case of bronchobiliary fistula is reported in an adult following liver laceration repair. Since patients with bronchobiliary fistula usually have poor lung condition preoperatively, perioperative respiratory management and intraoperative double-lumen tube insertion assists in the management of these patients.

Sukanya Mitra; Nidhi Bhatia; Nilanjan Dey; Usha Dalal

2009-01-01

83

Congenital Submandibular Salivary Gland Fistula  

Microsoft Academic Search

In this study, we present a patient with a congenital cervical submandibular gland fistula who was admitted to the hospital for nodular thyroid hyperplasia. After bilateral subtotal thyroidectomy, the fistula tract and the submandibular salivary gland on the right side of the neck and the obliterated sinus on the left side of the neck were excised. The pathological examination led

Vedat Durgun; Metin Kapan; Selin Kapan; Ender Onur

2003-01-01

84

A case of aortoesophageal fistula.  

PubMed

Aneurysms of the thoracic aorta can have various manifestations, some of which may simulate esophageal diseases, clinically and radiographically. Aortoesophageal fistula is rare and usually fatal. We report a case of aortoesophageal fistula presenting with progressive dysphagia and intermittent episodes of upper gastrointestinal bleeding. PMID:22160414

Bakhshandeh, Ali Reza; Salehi, Mehrdad; Radmehr, Hasan; Riahi, Gholam Reza

2011-12-01

85

Vaginal Mucormycosis: A Case Report  

PubMed Central

Although Zygomycetes cause life-threatening, opportunistic infections in immunocompromised hosts, the first case of vaginitis caused by Mucor species in a healthy woman is reported. Mucor vaginitis, which caused mild symptoms only, was refractory to conventional azole therapy and resistant to flucytosine. Cure was achieved with topical amphotericin B.

2001-01-01

86

CT scan of dural arteriovenous fistulas  

Microsoft Academic Search

CT was performed on ten cases of dural intracranial arteriovenous fistulas. There were 3 fistulas of the transverse sinus draining directly into the homolateral jugular vein; 2 fistulas of the sinus with distal occlusion of the sinus and back flow into the cortical veins (one was on the transverse sinus, the other on the sagittal sinus); 2 fistulas of the

J. Chiras; J. Bories; J. M. Leger; A. Gaston; M. Launay

1982-01-01

87

Heterogeneity of Vaginal Microbial Communities within Individuals? #  

PubMed Central

Recent culture-independent studies have revealed that a healthy vaginal ecosystem harbors a surprisingly complex assemblage of microorganisms. However, the spatial distribution and composition of vaginal microbial populations have not been investigated using molecular methods. Here, we evaluated site-specific microbial composition within the vaginal ecosystem and examined the influence of sampling technique in detection of the vaginal microbiota. 16S rRNA gene clone libraries were prepared from samples obtained from different locations (cervix, fornix, outer vaginal canal) and by different methods (swabbing, scraping, lavaging) from the vaginal tracts of eight clinically healthy, asymptomatic women. The data reveal that the vaginal microbiota is not homogenous throughout the vaginal tract but differs significantly within an individual with regard to anatomical site and sampling method used. Thus, this study illuminates the complex structure of the vaginal ecosystem and calls for the consideration of microenvironments when sampling vaginal microbiota as a clinical predictor of vaginal health.

Kim, Tae Kyung; Thomas, Susan M.; Ho, Mengfei; Sharma, Shobha; Reich, Claudia I.; Frank, Jeremy A.; Yeater, Kathleen M.; Biggs, Diana R.; Nakamura, Noriko; Stumpf, Rebecca; Leigh, Steven R.; Tapping, Richard I.; Blanke, Steven R.; Slauch, James M.; Gaskins, H. Rex; Weisbaum, Jon S.; Olsen, Gary J.; Hoyer, Lois L.; Wilson, Brenda A.

2009-01-01

88

Recurrent tracheoesophageal fistula.  

PubMed

Repair of recurrent tracheoesophageal fistulas (rTEFs) remains a technically challenging endeavor. Although considered the gold standard, open surgical repair is associated with significant morbidity and rates of recurrence. Over the last 40 years, endoscopic techniques have gained popularity and been touted as a safer first line treatment. This review complies the published articles related to endoscopic repair of rTEFs and reports the various techniques, number of interventions, and success rates. Controversy will remain as to which technique is superior until prospective, multi-institutional studies are performed. PMID:23720208

Lal, Dave R; Oldham, Keith T

2013-05-29

89

Management of tracheoesophageal fistulas in adults  

Microsoft Academic Search

Opinion statement  The approach to treatment of adult patients with tracheoesophageal fistulas depends on whether the fistula is congenital or\\u000a acquired in origin. Most adults have acquired tracheoesophageal fistulas, and treatment depends on whether the fistula is\\u000a a result of a benign process or a malignancy, with the latter usually primary esophageal cancer. For patients with benign\\u000a tracheoesophageal fistulas, treatment is

Shailendra S. Chauhan; John D. Long

2004-01-01

90

Non-inferiority of short-term urethral catheterization following fistula repair surgery: study protocol for a randomized controlled trial  

PubMed Central

Background A vaginal fistula is a devastating condition, affecting an estimated 2 million girls and women across Africa and Asia. There are numerous challenges associated with providing fistula repair services in developing countries, including limited availability of operating rooms, equipment, surgeons with specialized skills, and funding from local or international donors to support surgeries and subsequent post-operative care. Finding ways of providing services in a more efficient and cost-effective manner, without compromising surgical outcomes and the overall health of the patient, is paramount. Shortening the duration of urethral catheterization following fistula repair surgery would increase treatment capacity, lower costs of services, and potentially lower risk of healthcare-associated infections among fistula patients. There is a lack of empirical evidence supporting any particular length of time for urethral catheterization following fistula repair surgery. This study will examine whether short-term (7 day) urethral catheterization is not worse by more than a minimal relevant difference to longer-term (14 day) urethral catheterization in terms of incidence of fistula repair breakdown among women with simple fistula presenting at study sites for fistula repair service. Methods/Design This study is a facility-based, multicenter, non-inferiority randomized controlled trial (RCT) comparing the new proposed short-term (7 day) urethral catheterization to longer-term (14 day) urethral catheterization in terms of predicting fistula repair breakdown. The primary outcome is fistula repair breakdown up to three months following fistula repair surgery as assessed by a urinary dye test. Secondary outcomes will include repair breakdown one week following catheter removal, intermittent catheterization due to urinary retention and the occurrence of septic or febrile episodes, prolonged hospitalization for medical reasons, catheter blockage, and self-reported residual incontinence. This trial will be conducted among 512 women with simple fistula presenting at 8 study sites for fistula repair surgery over the course of 24 months at each site. Discussion If no major safety issues are identified, the data from this trial may facilitate adoption of short-term urethral catheterization following repair of simple fistula in sub-Saharan Africa and Asia. Trial registration ClinicalTrials.gov Identifier NCT01428830.

2012-01-01

91

Pharyngocutaneous fistula following total laryngectomy  

PubMed Central

Summary Pharyngocutaneous fistula is the most common complication after total laryngectomy. The aim of the study was to establish the incidence of this complication in our series and analyse the predisposing factors. This is a retrospective study comprising 55 patients who underwent total laryngectomy. The following aspects were considered: sex, age, tumour site, pathologic staging according to TNM, performance and type of neck dissection, previous radiation therapy, previous tracheotomy, Cumulative Illness Rating Scale for comorbidity analysis, the use of stapler for pharyngeal closure, and peri-operative blood transfusion. In the cases of pharyngocutaneous fistula, we considered the post-operative period in which it was diagnosed, duration, period of hospitalization, as well as therapeutic approach and the eventual result of this treatment. Pharyngocutaneous fistula was diagnosed in 7 patients (12.7%). There were no statistically significant associations between fistula development and sex (p = 1.000), previous radiation therapy (p = 0.354), stapler closure (p = 0.577), comorbidity (p = 1.000) or tumour site (p = 0.926). Patients previously submitted to tracheotomy presented higher fistula incidence (60%), compared to those that had not undergone this procedure (8%) (p = 0.012). Elderly patients (> 60 years) were also more predisposed to fistula development (p = 0.051). Although without statistical significance, fistula development was also associated with peri-operative blood transfusion, T stage, and type of neck dissection.

Dedivitis, RA; Ribeiro, KCB; Castro, MAF; Nascimento, PC

2007-01-01

92

Idiopathic fistula-in-ano  

PubMed Central

Fistula-in-ano is the most common form of perineal sepsis. Typically, a fistula includes an internal opening, a track, and an external opening. The external opening might acutely appear following infection and/or an abscess, or more insiduously in a chronic manner. Management includes control of infection, assessment of the fistulous track in relation to the anal sphincter muscle, and finally, definitive treatment of the fistula. Fistulotomy was the most commonly used mode of management, but concerns about post-fistulotomy incontinence prompted the use of sphincter preserving techniques such as advancement flaps, fibrin glue, collagen fistula plug, ligation of the intersphincteric fistula track, and stem cells. Many descriptive and comparative studies have evaluated these different techniques with variable outcomes. The lack of consistent results, level I evidence, or long-term follow-up, as well as the heterogeneity of fistula pathology has prevented a definitive treatment algorithm. This article will review the most commonly available modalities and techniques for managing idiopathic fistula-in-ano.

Shawki, Sherief; Wexner, Steven D

2011-01-01

93

Vaginal oxytetracycline concentrations.  

PubMed

Although tetracycline preparations are widely used in departments of genitourinary medicine, or sexually transmitted diseases clinics, little is known of the concentrations of these preparations in genital secretions. For this reason a microbiological method was used for estimating oxytetracycline concentrations in vaginal secretions. These concentrations varied from 0.6 to 6.5 microgram/ml in 19 women who had had sexual contact with a man with non-specific urethritis and who were taking oxytetracycline dihydrate 250 mg four times daily. They were well in excess of the minimum inhibitory concentration of oxytetracycline (0.2 microgram/ml) for the strains of Chlamydia trachomatis isolated from the patients with positive culture results. Thus, oxytetracycline 250 mg four times daily appears to be a satisfactory regimen for the treatment of chlamydial genital infection in women. PMID:509190

Thin, R N; Al Rawi, Z H; Simmons, P D; Treharne, J; Tabaqchali, S

1979-10-01

94

Myiasis of a perineal fistula.  

PubMed

We report a case of myiasis of a rectocutaneous fistula in a subject suffering from bone metastases after surgical resection of a neoplastic bladder. The fistula was infested by maggots identified as third-instar larvae of flies belonging to the family Sarcophagidae, genus Sarcophaga. The infestation was neither intestinal nor pseudointestinal; it was probably caused by a fly ovipositing on the fistula of the patient while having wound care at home, even though the possibility that the infestation might have occurred during hospitalization cannot be ruled out. PMID:12701384

Zardi, E M; Iori, A; Picardi, A; Costantino, S; Petrarca, V

2002-12-01

95

Enterocutaneous fistulas: an unusual solution.  

PubMed

Enterocutaneous fistulas are not a minor problem in gastrointestinal tract surgery. Significant reduction of mortality and morbidity has been attained but they still remain high. The authors report three clinical cases in which they sealed and treated enterocutaneous, chronic, iatrogenic fistulas by injecting biological glue (N-Butil 2-Cyanoacrylate-Histoacryl) into the internal opening and fistulous tract. We believe that the technic we propose here, in the proper setting, may be an important contribution to the management of iatrogenic (postoperative) enterocutaneous fistulas. PMID:9261604

Santos, F; Campos, J; Freire, J; Andrade, A; Távora, I; Castelo, H B

96

Vaginal Yeast Infections (For Parents)  

MedlinePLUS

... infection is simple and painless. What Is a Yeast Infection? A yeast infection, also known as candidiasis ( ... you can be treated appropriately. Do Guys Get Yeast Infections? Guys don't get vaginal yeast infections, ...

97

Desquamative inflammatory vaginitis. A review.  

PubMed Central

Desquamative inflammatory vaginitis is an uncommon cause of an intractable vaginitis often accompanied by serious dyspareunia, which can occur at any stage of reproductive life and after the menopause. The cytological changes are identical with those seen in atrophic vaginitis yet the disorder often occurs in the presence of apparently normal ovarian function. Vaginal synechiae and stenosis develop in an appreciable number of patients. Treatment is unsatisfactory though there is some response to either local or systemic steroid therapy. The literature is reviewed and the association of some cases with lichen planus of the mouth and genitals discussed. Its causation and natural history remain largely unknown and there is as yet, insufficient evidence to regard it as a single entity. It is likely that the incidence of the disorder is underestimated.

Oates, J K; Rowen, D

1990-01-01

98

Tracheoesophageal fistula repair - series (image)  

MedlinePLUS

... very ill, and therefore require a staged procedure. This involves placing a tube in the stomach (gastrostomy tube), in order to decompress the stomach and prevent fluid in the stomach from flowing up the esophagus, through the fistula and into ...

99

Interventional Management of Gastrointestinal Fistulas  

PubMed Central

Gastrointestinal (GI) fistulas are frequently very serious complications that are associated with high morbidity and mortality. GI fistulas can cause a wide array of pathophysiological effects by allowing abnormal diversion of the GI contents, including digestive fluid, water, electrolytes, and nutrients, from either one intestine to another or from the intestine to the skin. As an alternative to surgery, recent technical advances in interventional radiology and percutaneous techniques have been shown as advantageous to lower the morbidity and mortality rate, and allow for superior accessibility to the fistulous tracts via the use of fistulography. In addition, new interventional management techniques continue to emerge. We describe the clinical and imaging features of GI fistulas and outline the interventional management of GI fistulas.

Kwon, Se Hwan; Kim, Hyoung Jung; Park, Sun Jin; Park, Ho Chul

2008-01-01

100

[Surgical treatment of duodenal fistulae].  

PubMed

The experience of surgical treatment of 10 patients with external intestinal fistulae was analyzed. The plot of the operation was to exlude the duodenum from the digestion by performing the retrocolic gastroenteroanastomosis after Roux or on the ultrashort loop. Early operation prevent septic complications and electrolyte disbalance. Duodenal fistulae, developed on the background of pancreonecrosis or after endoscopic retrograde cholangiopancreaticography, necessitate the external choledochial drainage. PMID:22678537

Zakharash, M P; Bekmuradov, A R; Zakharash, Iu M; Stetsenko, A P; Tarasiuk, T V; Moroz, V V

2012-01-01

101

Fibrin Glue for Anal Fistulas  

Microsoft Academic Search

PURPOSE: The aim of this study was to evaluate the long-term success and complication rate of fibrin-glue treatment of anal fistulas. METHODS: Patients with an anal fistula presenting to a single surgeon over a three-year period were enrolled in this study. At their first operation, all 48 patients (26–72 years old) underwent anoscopy, biopsy, destruction of the internal gland, and

Stephen M. Sentovich

2003-01-01

102

Tracheoesophageal fistula and esophageal atresia repair  

MedlinePLUS

Tracheoesophageal fistula and esophageal atresia repair is surgery to repair two birth defects in your esophagus and trachea. ... not connect with the lower esophagus and stomach. Tracheoesophageal fistula (TEF) is a connection between the upper part ...

103

An unusual case of primary arteriocolic fistula.  

PubMed

A case is presented of lower digestive bleeding, caused by a fistula between a right iliac artery aneurysm and the sigmoid colon. Particular aspects of this unusual fistula are discussed from a diagnostic and therapeutic point of view. PMID:6972291

Smeesters, C J; Quenneville, G; Brossoit, R; Hurtubise, M; Giroux, L M; Ayroud, Y; Daloze, P M

104

Impact of vaginal ascorbic acid on abnormal vaginal microflora.  

PubMed

PURPOSE: To evaluate the impact of vaginal ascorbic acid (vitamin C) as a treatment/maintenance regimen on increased vaginal pH and abnormal microflora on wet mounts in premenopausal women. METHODS: A randomized study of 140 asymptomatic, low-risk pregnant and non-pregnant premenopausal women with vaginal pH ? 4.5 and a variety of partly/completely disrupted Lactobacillus microflora patterns on wet mounts in five outpatient clinics was carried out. Participants were randomized to the intervention group [250 mg vitamin C tablets vaginally at bedtime once a day for 6 days (treatment phase), followed by a one tablet per week, for 12 weeks (maintenance phase)] or the control group (no treatment). Outcomes were evaluated 4 months after randomizing, i.e., 2-3 weeks after the last vitamin C tablet insertion. RESULTS: Normalization to normal flora was observed in 51.4 % of all ascorbic acid and in 24.3 % of control group patients (difference 27.1 %, 95 % CI 11.7-42.6, p < 0.05, ITT population). In the per protocol population, normalization was confirmed in 53.5 % of the intervention and 22.4 % of the control group (difference 31 %, 95 % CI 14.3-47.8, p < 0.05). Results of pregnant subgroup analysis showed better outcomes for the subgroup: difference of normalization rate between ascorbic acid and control group was 41.2 % (95 % CI 21.8-60.1, p < 0.05). Itching occurred in 19 %; 23 % of women reported irritation and 10 % stopped the treatment because of side effects. CONCLUSIONS: Vaginal ascorbic acid improves abnormal vaginal pH and microflora, especially in pregnant women, but is not well tolerated by all women. PMID:23677418

Zodzika, Jana; Rezeberga, Dace; Donders, Gilbert; Vedmedovska, Natalija; Vasina, Olga; Pundure, Inara; Bite, Ruta; Silberga, Ingrida; Socenova, Julija; Melngaile, Olita

2013-05-16

105

[Multipurpose treatment of vaginal infections].  

PubMed

Untreated bacterial vaginosis is related with many complications for non-pregnant women in reproductive age, most common from them are vaginal discharge and postoperative infections. The aim of our investigation was to compare the effectiveness of two therapeutic regimes which consist in Macmiror/Macmiror Complex alone and in combination with Feminella Vagi C for treatment of bacterial vaginosis (BV) and/or mycotic infection. 117 non-pregnant women with symptoms of vaginal infection were prospectively enrolled into two groups according their treatment. First group consist 66 women treated with Macmiror tablets and vaginal capsules followed with local application of Feminella Vagi C, the second group consist 54 women treated with Macmiror tablets and vaginal capsules only. The impact of treatment on clinical symptoms was observed at the end of medication and 20 days after it. Microbiological testing was repeated 20 days after treatment. Over than 80% (78.6 divided by 86.7%) of the cases with vaginal infection (BV and mycotic one) were successfully treated with Macmiror/Macmiror Complex. Supplement treatment with Feminella Vagi C lead to higher percentage of clinically recovery (86.7% vs 84.6%), better microbiological cleaning (86.7% vs 82.1%) and longer effect of treatment. Used medication showed higher efficacy against BV than to fungal infection. According obtained results we may conclude that bacterial vaginosis was better treated with multipurpose treatment (Nifuratel, Nistatin and vit. C) than with Macmiror alone. PMID:23234030

Nikolov, A; Masseva, A; Shopova, E; Georgiev, S

2012-01-01

106

Spontaneous pancreatic duct-colon fistula.  

PubMed

A fistula between the pancreatic duct and the colon is quite rare and usually associated with such manifestations as bleeding and sepsis. We have seen a patient with such a fistula detected almost incidentally at ERCP. We report the course of this fistula and review the literature to suggest a place for conservative surgical management. PMID:3517133

Thomas, C T; Hinton, P J; Thomas, E

1986-02-01

107

Vesicocutaneous fistula caused by giant vesical calculus.  

PubMed

Vesicocutaneous fistula is an extremely rare complication of vesical calculus.To our knowledge only three cases have been reported in the World literature. Because of its rarity, here we report a case of vesicocutaneous fistula caused by giant vesical calculus. This is probably the fourth case of vesicocutaneous fistula caused by giant vesical calculus. PMID:22468068

Deshmukh, Santoshkumar Nagnath; Maske, Audumbar N; Deshpande, Akshay P; Shende, Shweta P

2010-11-23

108

Intracranial dural arteriovenous fistulas: A Review  

PubMed Central

Dural arteriovenous fistulas are fistulas connecting the branches of dural arteries to dural veins or a venous sinus. Digital subtraction angiography remains the gold standard for diagnosing these fistulas. Endovascular treatment is one of the first line options available for their management. This review article reviews the etiopathogenesis, natural history, common classification systems and various available treatment options.

Gupta, AK; Periakaruppan, AL

2009-01-01

109

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2010 CFR

...3900 Vaginal stent. (a) Identification. A vaginal stent is a device used to enlarge the vagina by stretching, or to support the vagina and to hold a skin graft after reconstructive surgery. (b) Classification. Class II...

2010-04-01

110

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2013 CFR

...AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Prosthetic Devices § 884.3900 Vaginal stent. (a) Identification. A vaginal stent is a device used to enlarge the...

2013-04-01

111

Do We Know What Causes Vaginal Cancer?  

MedlinePLUS

... section " What are the risk factors for vaginal cancer? " Research is now being done to learn more about ... Your Doctor After Treatment What`s New in Vaginal Cancer Research? Other Resources and References Cancer Information Cancer Basics ...

112

Surgery for fistula-in-ano in a specialist colorectal unit: a critical appraisal  

PubMed Central

Background Several techniques have been described for the management of fistula-in-ano, but all carry their own risks of recurrence and incontinence. We conducted a prospective study to assess type of presentation, treatment strategy and outcome over a 5-year period. Methods Between 1st January 2005 and 31st March 2011 247 patients presenting with anal fistulas were treated at the University Hospital Tor Vergata and were included in the present prospective study. Mean age was 47 years (range 16-76 years); minimum follow-up period was 6 months (mean 40, range 6-74 months). Patients were treated using 4 operative approaches: fistulotomy, fistulectomy, seton placement and rectal advancement flap. Data analyzed included: age, gender, type of fistula, operative intervention, healing rate, postoperative complications, reinterventions and recurrence. Results Etiologies of fistulas were cryptoglandular (n = 218), Crohn's disease (n = 26) and Ulcerative Colitis (n = 3). Fistulae were classified as simple -intersphincteric 57 (23%), low transphincteric 28 (11%) and complex -high transphicteric 122 (49%), suprasphincteric 2 (0.8%), extrasphinteric 2 (0.8%), recto-vaginal 7 (2.8%) Crohn 26 (10%) and UC 3 (1.2%). The most common surgical procedure was the placement of seton (62%), usually applied in case of complex fistulae and Crohn's patients. Eighty-five patients (34%) underwent fistulotomy, mainly for intersphincteric and mid/low transphincteric tracts. Crohn's patients were submitted to placement of one or more loose setons. The main treatment successfully eradicated the primary fistula tract in 151/247 patients (61%). Three cases of major incontinence (1.3%) were detected during the follow-up period; Furthermore, three patients complained minor incontinence that was successfully treated by biofeedback and permacol injection into the internal anal sphincter. Conclusions This prospective audit demonstrates an high proportion of complex anal fistulae treated by seton placement that was the most common surgical technique adopted to treat our patients as a first line. Nevertheless, a good outcome was achieved in the majority of patients with a limited rate of faecal incontinence (6/247 = 2.4%). New technologies provide promising alternatives to traditional methods of management particularly in case of complex fistulas. There is, however, a real need for high-quality randomized control trials to evaluate the different surgical and non surgical treatment options.

2011-01-01

113

Evaluation and management of vaginitis  

Microsoft Academic Search

OBJECTIVE: To evaluate recent advances in our understanding of the clinical relevance, diagnosis, and treatment of vaginal infections,\\u000a and to determine an efficient and effective method of evaluating this clinical problem in the outpatient setting.\\u000a \\u000a \\u000a DATA SOURCES: Relevant papers on vaginitis limited to the English language obtained through a MEDLINE search for the years 1985 to 1997\\u000a were reviewed.\\u000a \\u000a \\u000a \\u000a \\u000a DATA

Phyllis L. Carr; Donna Felsenstein; Robert H. Friedman

1998-01-01

114

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2010 CFR

...2009-04-01 2009-04-01 false Vaginal stent. 884.3900 Section 884.3900 Food and...Prosthetic Devices § 884.3900 Vaginal stent. (a) Identification. A vaginal stent is a device used to enlarge the vagina...

2009-04-01

115

Vaginal douching practices and beliefs in Turkey  

Microsoft Academic Search

The aim of this study was to identify women's motivations for vaginal douching, vaginal douching practices, and women's reactions to situations that discourage vaginal douching. Research took place in the outskirts of Antalya, a city located on the Mediterranean coast of Turkey. A total of 776 women participated in the study. Age, religious affiliation, place of residence, and poverty were

Kamile Kukulu

2006-01-01

116

Embolotherapy of an Arterioportal Fistula  

SciTech Connect

We present a complex case of a splanchnic arterioportal vein fistula in a patient who presented with weight loss, abdominal pain, diarrhea, and pancreatitis. We report successful use of the Guglielmi Detachable Coil (GDC) and N-butyl cyanoacrylate glue for the therapeutic embolization of the fistula between the superior mesenteric artery, the common hepatic artery, and the portal vein. On the day following the procedure, the patient reported total remission of the abdominal pain and diarrhea. These results were maintained at 3 months follow-up.

Chen, Qi, E-mail: qc13@Cornell.edu; Tack, Carl; Morcos, Morcos; Ruggiero, Mary Ann; Schlossberg, Peter; Fogel, Joshua [Maimonides Medical Center, Department of Radiology (United States); Weng Lijun [New York Methodist Hospital, Department of Radiology (United States); Farkas, Jeffrey [Maimonides Medical Center, Department of Radiology (United States)

2007-09-15

117

Current Concepts of Treating Vaginitis  

PubMed Central

Vaginitis can be a frustrating entity to treat, since the incidence of recurrence is high. This paper examines evidence from the literature concerning diagnosis and treatment of Candida albicans, Trichomonas vaginalis, Corynebacterium vaginale, herpes simplex type 2 and gonorrhea. A protocol based on these readings is outlined.

Robinson, Theresa

1977-01-01

118

Operative vaginal delivery - Year 2000  

Microsoft Academic Search

Literature review was performed to analyze and define the current state of operative vaginal delivery. On the basis of published data, it is concluded that outlet and low forceps deliveries with ?45 degrees of rotation are effective and safe for both mother and baby. The greatest risk to mother or fetus occurs with operations performed at the 0 or +1

Gary D. V. Hankins; Thomas F. Rowe

1996-01-01

119

Vaginal birth after cesarean section  

Microsoft Academic Search

Vaginal birth after cesarean section (VBAC) is safe, cost effective, and the preferred obstetrical option for most parturients in health care settings which are equipped to manage intrapartum emergencies. Since 1981, cesarean sections have been the most frequently performed major surgical procedure in the United States. Approximately 1,000,000 cesarean deliveries are performed in the United States per year. The rate

Jordan Pritzker

1996-01-01

120

New technique for the management of vesicorectal fistulas  

SciTech Connect

We report a new technique for the management of the complications of vesicorectal fistulas. The patient we present had a fistula and severe skin excoriation. The fistula was caused by carcinoma of the prostate that had been treated by radiation therapy. The fistula was patched with a rectal prosthesis similar to that used to patch esophageal-tracheal and esophageal-bronchial fistulas.

Leifer, G.; Jacobs, W.H.

1988-08-01

121

Gastrocolic fistula in Crohn's disease.  

PubMed

The surgeon managing a patient with Crohn's disease should be aware of the possibility of a gastrocolic fistula being present. Readily available roentgenographic contrast studies, coupled with endoscopy, will undoubtedly provide all the necessary information with which to undertake a safe one stage en bloc resection of the diseased segments. PMID:644428

Kokal, W; Pickleman, J; Steinberg, J J; Banich, F E

1978-05-01

122

Vaginal Redox Potential in Bacterial Vaginosis (Nonspecific Vaginitis)  

Microsoft Academic Search

To explore of the association of bacterial vaginosis with anaerobic bacterial growth in the vagina, we measured the redox potential ($E_{h}$) at the vaginal epithelial surface of women with this syndrome. Among normal women, the value for $E_{h}$ in the vagina ranged from +322 mV to +137 mV (mean, +170 mV); whereas among women with bacterial vaginosis, the $E_{h}$ ranged

King K. Holmes; Kirk C. S. Chen; Carolyn M. Lipinski; David A. Eschenbach

1985-01-01

123

Antigonococcal effects of vaginal tampons.  

PubMed Central

Different brands of vaginal tampons varied significantly (p less than 0.0001) in their anti-bacterial effects when tested with 46 strains of Neisseria gonorrhoeae. Gonococcal strains recovered from patients with disseminated infections were substantially more sensitive to the anti-bacterial effects of tampons than were strains from patients with uncomplicated genital infections. Strains from patients with pelvic inflammatory disease were moderately sensitive. Tampons showing strong in-vitro antigonococcal effects were also generally effective in vivo in eliminating gonococcal infections from subcutaneous chambers in mice. Extracts of the Rely tampon showed no in-vitro antigonococcal effect, however, but did induce antibacterial activity when injected into subcutaneous chambers in mice. These results emphasise the importance of both in-vitro as well as in-vivo testing of tampon materials to elucidate more fully the nature of their antibacterial effects and their potential for affecting vaginal pathogens and disease processes.

Arko, R J; Wong, K H; Smith, S J; Finley-Price, K G

1983-01-01

124

Vacuum-Assisted Vaginal Delivery  

PubMed Central

Approximately 5% (1 in 20) of all deliveries in the United States are operative vaginal deliveries. The past 20 years have seen a progressive shift away from the use of forceps in favor of the vacuum extractor as the instrument of choice. This article reviews in detail the indications, contraindications, patient selection criteria, choice of instrument, and technique for vacuum-assisted vaginal delivery. The use of vacuum extraction at the time of cesarean delivery will also be discussed. With vacuum extraction becoming increasingly popular, it is important that obstetric care providers are aware of the maternal and neonatal risks associated with such deliveries and of the options available to effect a safe and expedient delivery.

Ali, Unzila A; Norwitz, Errol R

2009-01-01

125

Uterine and Vaginal Vault Prolapse  

Microsoft Academic Search

The surgical management of pelvic organ prolapse is more challenging than that for stressurinary incontinence, and detection\\u000a and correction of apical repairs can be the most difficult of all pelvic floor defects. One-third of procedures performed\\u000a for pelvic organ prolapse are secondary procedures (1). The number of procedures performed in the United States to treat posthysterectomy vaginal vault prolapse increased

Peggy A. Norton

126

Pulse granuloma in a rectocutaneous fistula.  

PubMed

Pulse granulomas are rare foreign body reactions to vegetable material characterized by hyaline rings or starch granules. Pulse granulomas have mainly been reported in association with lung aspirations, the oral cavity with a history of oral procedures and less frequently in intestinal fistulae, colonic diverticulae or stomach ulcers. Only one case involving the skin has been reported in a patient with jejunocutaneous and ileocutaneous fistulae. We report the second cutaneous pulse granuloma in a patient with a rectocutaneous fistula. PMID:18251753

Tschen, Jose A; Tschen, Jaime A

2008-03-01

127

A bizarre cause of extensive oronasal fistula.  

PubMed

Oronasal fistula is defined as an abnormal duct, connecting the nasal with the oral cavity. We present an extremely rare case of oronasal fistula associated with rhinolithiasis. The particular case presents the unique feature of a palatal defect, being large enough to enable the in toto removal of the rhinolith. A 2-layer closure of the fistula was finally undertaken, by utilizing a vestibular and a palatal mucoperiosteal flap. PMID:24036823

Igoumenakis, Dimosthenis; Athanasiou, Spyridon; Mezitis, Michael

2013-09-01

128

High incidence of vesico-ureteral reflux in mice with deletion of fibroblast growth factor receptor 2 in kidney mesenchyme  

PubMed Central

Purpose Mice with conditional deletion of fibroblast growth factor receptor 2 (Fgfr2) in metanephric mesenchyme (Fgfr2Mes?/?) have ureteric bud induction abnormalities. Our goal was to determine if Fgfr2Mes?/? mutants developed abnormally positioned ureters predisposing to vesico-ureteral reflux (VUR). Materials and Methods We measured common nephric duct (CND) lengths and assayed for apoptosis in embryonic day (E) 11.5 mice. We performed 3 dimensional (3D) reconstructions of and real time PCR and whole mount in situ hybridization for Fgfr2 in urinary tracts in E15.5 embryos. We performed cystograms followed by 3D reconstructions in postnatal animals. Results Compared with controls, Fgfr2Mes?/? embryos had increased CND lengths (with no differences in apoptosis) indicating cranially displaced ureteric buds. 3-D reconstructions at E15.5 showed low insertions of ureters into the bladder (near bladder necks) in Fgfr2Mes?/? mice. Postnatal Fgfr2Mes?/? mutants had high rates of VUR compared with controls (47.4% vs. 4.0%, p=0.00006). In postnatal mutants with unilateral reflux, the refluxing ureters inserted closer to the bladder neck than non-refluxing ureters. The external ureteral insertional angles at the outer bladder wall (formed by the ureteral insertion points and bladder neck) were greater in mutant refluxing ureters compared to contralateral non-refluxing ureters and to control ureters. At E15.5, Fgfr2 levels were decreased in Fgfr2Mes?/? kidneys compared with controls, but were not statistically different in ureters or bladders. Conclusions Fgfr2Mes?/? mice have ureteric induction abnormalities, associated with abnormal ureteral insertion in the bladder and subsequent VUR, consistent with the Mackie and Stephens hypothesis.

Hains, David S.; Sims-Lucas, Sunder; Carpenter, Ashley; Saha, Monalee; Murawski, Inga; Kish, Kayle; Gupta, Indra; McHugh, Kirk; Bates, Carlton M.

2013-01-01

129

Vaginal cuff dehiscence after vaginal cuff brachytherapy for uterine cancer. A case report  

PubMed Central

Vaginal cuff dehiscence is a rare, but potentially serious complication after total hysterectomy. We report a case of vaginal cuff dehiscence after vaginal cuff brachytherapy. A 62 year old female underwent a robotic-assisted laparoscopic hysterectomy with bilateral salpingo-oophorectomy, and was found to have International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB endometrioid adenocarcinoma of the uterus. The patient was referred for adjuvant vaginal cuff brachytherapy. During the radiation treatment simulation, a computerized tomography (CT) of the pelvis showed abnormal position of the vaginal cylinder. She was found to have vaginal cuff dehiscence that required immediate surgical repair. Vaginal cuff dehiscence triggered by vaginal cuff brachytherapy is very rare with only one case report in the literature.

Cattaneo, Richard; Bellon, Maria

2013-01-01

130

The vaginal microbiome: rethinking health and diseases  

PubMed Central

Vaginal microbiota form a mutually beneficial relationship with their host and have major impact on health and disease. In recent years our understanding of vaginal bacterial community composition and structure has significantly broadened as a result of investigators using cultivation-independent methods based on the analysis of 16S ribosomal RNA (rRNA) gene sequences. In asymptomatic, otherwise healthy women, several kinds of vaginal microbiota exist, the majority often dominated by species of Lactobacillus, while others comprise a diverse array of anaerobic microorganisms. Bacterial vaginosis is the most common vaginal conditions and is vaguely characterized as the disruption of the equilibrium of the ‘normal’ vaginal microbiots. A better understanding of ‘normal’ and ‘healthy’ vaginal ecosystems that is based on its ‘true’ function and not simply on its composition would help better define health and further improve disease diagnostics as well as the development of more personalized regimens to promote health and treat diseases.

Ma, Bing; Forney, Larry J.; Ravel, Jacques

2013-01-01

131

Imaging features of colovesical fistulae on MRI  

PubMed Central

Objectives MRI is routinely used in the investigation of colovesical fistulae at our institute. Several papers have alluded to its usefulness in achieving the diagnosis; however, there is a paucity of literature on its imaging findings. Our objective was to quantify the MRI characteristics of these fistulae. Methods We selected all cases over a 4-year period with a final clinical diagnosis of colovesical fistula which had been investigated with MRI. The MRI scans were reviewed in a consensus fashion by two consultant uroradiologists. Their MRI features were quantified. Results There were 40 cases of colovesical fistulae. On MRI, the fistula morphology consistently fell into three patterns. The most common pattern (71%) demonstrated an intervening abscess between the bowel wall and bladder wall. The second pattern (15%) had a visible track between the affected bowel and bladder. The third pattern (13%) was a complete loss of fat plane between the affected bladder and bowel wall. MRI correctly determined the underlying aetiology in 63% of cases. Conclusions MRI is a useful imaging modality in the diagnosis of colovesical fistulae. The fistulae appear to have three characteristic morphological patterns that may aid future diagnoses of colovesical fistulae. To the authors' knowledge, this is the first publication of the MRI findings in colovesical fistulae.

Tang, Y Z; Booth, T C; Swallow, D; Shahabuddin, K; Thomas, M; Hanbury, D; Chang, S; King, C

2012-01-01

132

Pancreatic choledochal fistula complicating acute pancreatitis  

PubMed Central

Summary Background: Biliary tract involvement in acute necrotizing pancreatitis is rare. Case Report: We report a case of a 53-year-old man who had a pancreatic choledochal fistula complicating acute necrotizing pancreatitis. The fistula was suspected at computed tomography and confirmed at surgery. The patient underwent necrosectomy, cholecystectomy and proximal biliary diversion. He is well at 1-year follow-up. Conclusions: Simultaneous presence of air in the biliary tree and pancreatic collection is highly suggestive of a pancreaticobiliary fistula. Pancreatic necrosectomy and proximal biliary diversion resulted in closure of the fistula.

Brar, Rahat; Singh, Iqbal; Brar, Preetinder; Prasad, Abhishek; Doley, Rudra Prasad; Wig, Jai Dev

2012-01-01

133

German S3-Guideline: Rectovaginal fistula  

PubMed Central

Background: Rectovaginal fistulas are rare, and the majority is of traumatic origin. The most common causes are obstetric trauma, local infection, and rectal surgery. This guideline does not cover rectovaginal fistulas that are caused by chronic inflammatory bowel disease. Methods: A systematic review of the literature was undertaken. Results: Rectovaginal fistula is diagnosed on the basis of the patient history and the clinical examination. Other pathologies should be ruled out by endoscopy, endosonography or tomography. The assessment of sphincter function is valuable for surgical planning (potential simultaneous sphincter reconstruction). Persistent rectovaginal fistulas generally require surgical treatment. Various surgical procedures have been described. The most common procedure involves a transrectal approach with endorectal suture. The transperineal approach is primarily used in case of simultaneous sphincter reconstruction. In recurrent fistulas. Closure can be achieved by the interposition of autologous tissue (Martius flap, gracilis muscle) or biologically degradable materials. In higher fistulas, abdominal approaches are used as well. Stoma creation is more frequently required in rectovaginal fistulas than in anal fistulas. The decision regarding stoma creation should be primarily based on the extent of the local defect and the resulting burden on the patient. Conclusion: In this clinical S3-Guideline, instructions for diagnosis and treatment of rectovaginal fistulas are described for the first time in Germany. Given the low evidence level, this guideline is to be considered of descriptive character only. Recommendations for diagnostics and treatment are primarily based the clinical experience of the guideline group and cannot be fully supported by the literature.

Ommer, Andreas; Herold, Alexander; Berg, Eugen; Furst, Alois; Schiedeck, Thomas; Sailer, Marco

2012-01-01

134

Enterovesical fistulas: diagnosis and management  

Microsoft Academic Search

Enterovesical fistula (EVF) is an abnormal communication between the intestine and the bladder. It represents a rare complication\\u000a of inflammatory or neoplastic disease, and traumatic or iatrogenic injuries. The most common aetiologies are diverticular\\u000a disease and colorectal carcinoma. Over 75% of affected patients describe pathognomonic features of pneumaturia, faecaluria\\u000a and recurrent urinary tract infections. The diagnosis of EVF can be

G. Scozzari; A. Arezzo; M. Morino

2010-01-01

135

Carotid Cavernous Fistula: Ophthalmological Implications  

PubMed Central

Carotid cavernous fistula (CCF) is an abnormal communication between the cavernous sinus and the carotid arterial system. A CCF can be due to a direct connection between the cavernous segment of the internal carotid artery and the cavernous sinus, or a communication between the cavernous sinus, and one or more meningeal branches of the internal carotid artery, external carotid artery or both. These fistulas may be divided into spontaneous or traumatic in relation to cause and direct or dural in relation to angiographic findings. The dural fistulas usually have low rates of arterial blood flow and may be difficult to diagnose without angiography. Patients with CCF may initially present to an ophthalmologist with decreased vision, conjunctival chemosis, external ophthalmoplegia and proptosis. Patients with CCF may have predisposing causes, which need to be elicited. Radiological features may be helpful in confirming the diagnosis and determining possible intervention. Patients with any associated visual impairment or ocular conditions, such as glaucoma, need to be identified and treated. Based on patient's signs and symptoms, timely intervention is mandatory to prevent morbidity or mortality. The conventional treatments include carotid ligation and embolization, with minimal significant morbidity or mortality. Ophthalmologist may be the first physician to encounter a patient with clinical manifestations of CCF, and this review article should help in understanding the clinical features of CCF, current diagnostic approach, usefulness of the available imaging modalities, possible modes of treatment and expected outcome.

Chaudhry, Imtiaz A.; Elkhamry, Sahar M.; Al-Rashed, Waleed; Bosley, Thomas M.

2009-01-01

136

Carotid cavernous fistula: ophthalmological implications.  

PubMed

Carotid cavernous fistula (CCF) is an abnormal communication between the cavernous sinus and the carotid arterial system. A CCF can be due to a direct connection between the cavernous segment of the internal carotid artery and the cavernous sinus, or a communication between the cavernous sinus, and one or more meningeal branches of the internal carotid artery, external carotid artery or both. These fistulas may be divided into spontaneous or traumatic in relation to cause and direct or dural in relation to angiographic findings. The dural fistulas usually have low rates of arterial blood flow and may be difficult to diagnose without angiography. Patients with CCF may initially present to an ophthalmologist with decreased vision, conjunctival chemosis, external ophthalmoplegia and proptosis. Patients with CCF may have predisposing causes, which need to be elicited. Radiological features may be helpful in confirming the diagnosis and determining possible intervention. Patients with any associated visual impairment or ocular conditions, such as glaucoma, need to be identified and treated. Based on patient's signs and symptoms, timely intervention is mandatory to prevent morbidity or mortality. The conventional treatments include carotid ligation and embolization, with minimal significant morbidity or mortality. Ophthalmologist may be the first physician to encounter a patient with clinical manifestations of CCF, and this review article should help in understanding the clinical features of CCF, current diagnostic approach, usefulness of the available imaging modalities, possible modes of treatment and expected outcome. PMID:20142962

Chaudhry, Imtiaz A; Elkhamry, Sahar M; Al-Rashed, Waleed; Bosley, Thomas M

2009-04-01

137

What's New in Vaginal Cancer Research and Treatment?  

MedlinePLUS

... resources for vaginal cancer What`s new in vaginal cancer research and treatment? Research is under way to find ... Your Doctor After Treatment What`s New in Vaginal Cancer Research? Other Resources and References Cancer Information Cancer Basics ...

138

Gracilis Muscle Transposition for Iatrogenic Rectourethral Fistula  

PubMed Central

Objective To assess the utility of gracilis muscle transposition in the treatment of iatrogenic rectourethral fistula. Summary Background Data Iatrogenic rectourethral fistula poses a rare but challenging complication of treatment for prostate cancer. A variety of procedures have been described to treat this condition, none of which has gained acceptance as the procedure of choice. The aim of this study was to review the authors’ experience with gracilis muscle transposition in the treatment of iatrogenic rectourethral fistula. Methods A retrospective chart review of all patients who underwent gracilis muscle transposition for iatrogenic rectourethral fistula was performed, and follow-up was established by telephone interview. Successful repair was defined as absence of a fistula after reversal of fecal and urinary diversions. Results Eleven men, mean age of 62 years, underwent 12 gracilis muscle transpositions for rectourethral fistula between 1996 and 2001. Six patients had a history of pelvic radiotherapy, and five patients had previous failed attempts to repair the fistula. In nine patients, the fistula healed following gracilis muscle transposition. One patient developed a rectocutaneous fistula that healed with fibrin glue injection, and one developed perineal sepsis requiring debridement of the transposed gracilis. This patient underwent a second gracilis transposition, which uneventfully healed. Overall, all of the patients had closure of their diverting stomas and maintained healed rectourethral fistulas. There were no intraoperative complications, and the only long-term complication of this procedure was mild medial thigh numbness in two patients. Conclusions Gracilis muscle transposition is an effective surgical treatment for iatrogenic rectourethral fistula. It is associated with low morbidity and a high success rate.

Zmora, Oded; Potenti, Fabio M.; Wexner, Steven D.; Pikarsky, Alon J.; Efron, Jonathan E.; Nogueras, Juan J.; Pricolo, Victor E.; Weiss, Eric G.

2003-01-01

139

Outcomes of term vaginal breech delivery.  

PubMed

In December 2001, the American College of Obstetricians and Gynecologists revised their recommendations for breech delivery. These recommendations acknowledge that although a planned vaginal delivery may no longer be appropriate, there are instances in which vaginal breech delivery is inevitable. Moreover, there continues to be patients who for any number of reasons will choose vaginal over cesarean delivery when faced with a fetus in the breech presentation. We sought to review maternal and fetal outcomes in such circumstances when vaginal breech delivery occurs, and compare these outcomes to elective cesarean deliveries for breech presentation. We performed a retrospective review of all singleton breech deliveries at our county hospital from January 2002 through June 2003. We reviewed maternal age, ethnicity, gestational age, gravity, parity, birthweight, mode of delivery, Apgar scores, umbilical arterial blood gases, and maternal and infant complications of both cesarean deliveries and vaginal breech deliveries. Univariate and logistic regression statistical analyses were performed with NCSS software. We had a total of 150 term breech deliveries with gestational ages between 37 and 42 weeks. Of these, 41 were vaginal breech and 109 were cesarean deliveries. Greater than 95% of patients are of Hispanic origin. There were no statistically significant differences in maternal age, ethnicity, gravity, or gestational age. Mean birthweight was significantly lower and parity was significantly higher in the vaginal delivery group. There was also a higher proportion of patients who underwent labor induction/augmentation in the vaginal group. We found no differences in the outcomes of 5-minute Apgar scores, umbilical arterial blood gas values, neonatal intensive care unit admissions, deaths or maternal/fetal complications reported between the two groups. Mean umbilical arterial blood gas values were greater than 7.18 in both groups. Vaginal breech delivery cannot always be avoided. Moreover, at our county hospital several patients continue to choose vaginal breech delivery. Our data would suggest that vaginal breech delivery remains a viable option in selected patients. PMID:16118722

Doyle, Nora M; Riggs, John W; Ramin, Susan M; Sosa, Manuel A; Gilstrap, Larry C

2005-08-01

140

Bacterial vaginosis, vaginal flora patterns and vaginal hygiene practices in patients presenting with vaginal discharge syndrome in The Gambia, West Africa  

Microsoft Academic Search

BACKGROUND: Bacterial vaginosis (BV) – a syndrome characterised by a shift in vaginal flora – appears to be particularly common in sub-Saharan Africa, but little is known of the pattern of vaginal flora associated with BV in Africa. We conducted a study aimed at determining the prevalence of BV and patterns of BV-associated vaginal micro-flora among women with vaginal discharge

Edward Demba; Linda Morison; Maarten Schim van der Loeff; Akum A Awasana; Euphemia Gooding; Robin Bailey; Philippe Mayaud; Beryl West

2005-01-01

141

Incontinence and trauma: sexual violence, female genital cutting and proxy measures of gynecological fistula.  

PubMed

Obstetric fistula, characterized by urinary or fecal incontinence via the vagina, has begun to receive attention on the international public health agenda, however less attention has been given to traumatic fistula. Field reports indicate that trauma contributes to the burden of vaginal fistula, especially in regions wrought by civil unrest, however evidence is largely anecdotal or facility-based. This paper specifically examines the co-occurrence of incontinence and two potential sources of trauma: sexual violence and female genital cutting using the most recent Demographic and Health Surveys in Malawi, Rwanda, Uganda and Ethiopia. Multivariate selection models are used to control for sampling differences by country. Results indicate that sexual violence is a significant determinant of incontinence in Rwanda and Malawi, however not in Uganda. Simulations predict that elimination of sexual violence would result in from a 7 to a 40% reduction of the total burden of incontinence. In contrast, no evidence is found that female genital cutting contributes to incontinence and this finding is robust for types of cutting and high risk samples. Results point to the importance of reinforcing prevention programs which seek to address prevention of sexual violence and for the integration of services to better serve women experiencing both sexual violence and incontinence. PMID:19128867

Peterman, Amber; Johnson, Kiersten

2009-01-06

142

Posttraumatic intrapancreatic aortosplenic fistula causing portal hypertension.  

PubMed

Arterioportal fistulas are uncommon. The case of a patient with massive uncontrollable esophageal variceal bleeding is presented. Reversible portal hypertension was caused by a posttraumatic giant intrapancreatic aortosplenic fistula. Percutaneous closure was unsuccessful, and pancreatectomy was performed to control the bleeding. The case is discussed and the literature on this exceptional cause of portal hypertension is reviewed. PMID:14514565

Estrada, Oscar; Mestres, Carlos-A; López-Boado, Miguel-A; Salmerón, Juan A; Visa, José; García-Valdecasas, Juan-Carlos

2003-09-01

143

Surgical treatment of intracranial dural arteriovenous fistulas  

Microsoft Academic Search

BACKGROUNDWhen considering the treatment strategies for dural arteriovenous fistulas (DAVFs), it is important to clarify the exact location of the fistula and venous drainage route from both DAVFs and normal brain tissue. DAVFs with leptomeningeal retrograde venous drainage carry a high risk of neurological deficits and require aggressive treatment. When AVFs involve the dural sinus, transvenous embolization via the transfemoral

Satoshi Ushikoshi; Kiyohiro Houkin; Satoshi Kuroda; Takeshi Asano; Yoshinobu Iwasaki; Kazuo Miyasaka; Hiroshi Abe

2002-01-01

144

Arterio-Ureteric Fistula Following Iliac Angioplasty  

SciTech Connect

Arterio-ureteric fistulae are rare but can be associated with significant morbidity and mortality. We describe a novel case in which an arterio-ureteric fistula occurred as a complication following external iliac artery angioplasty and stenting, in a patient who had undergone previous pelvic surgery, radiotherapy, ureteric stenting, and urinary diversion surgery. Prompt recognition enabled successful endovascular management using a covered stent.

Aarvold, Alexander; Wales, Lucy, E-mail: l.wales@imperial.ac.uk; Papadakos, Nikolaos; Munneke, Graham; Loftus, Ian; Thompson, Matt [St. George's Vascular Institute (United Kingdom)

2008-07-15

145

Duodenocaval fistula: case report and literature review  

SciTech Connect

Duodenocaval fistulae are rare but may well be the source of gastrointestinal hemorrhage with associated sepsis in patients undergoing surgery and subsequently receiving radiation to the right upper abdomen. Management of these fistulae may be challenging. Diagnosis usually requires a high index of suspicion, particularly in post irradiated patients.

Rheudasil, J.M.; Chuang, V.P.; Amerson, J.R.

1988-03-01

146

Congenital tracheoesophageal fistula without esophageal atresia  

Microsoft Academic Search

The authors report a series of eight cases of isolated tracheoesophageal fistula without esophageal atresia (or an H type fistula), treated in three pediatric ENT departments. This is a rare malformation whose diagnosis requires investigation for associated anomalies. The clinical signs are mainly respiratory but also digestive and the symptomatology can be severe. The diagnosis can be made with a

Erwan Genty; Pierre Attal; Richard Nicollas; Gilles Roger; Jean-Michel Triglia; Erea-Noël Garabedian; Serge Bobin

1999-01-01

147

Vaginitis: Its Diagnosis and Treatment  

PubMed Central

Ninety-nine patients with a variety of specific and non-specific vaginitis were treated initially with a broad spectrum anti-microbial agent (AVC cream) in an effort to alleviate the acute symptoms of these problems even before specific organisms could be isolated. Diagnostic methods are discussed for Candida albicans and trichomonas vaginalis which could be employed in routine office practice. This agents advantage in being effective against almost all known pathogens, is offset by its some-what limited effectiveness against trichomoniasis. It has been shown in this study to be well tolerated, and it offers an overall cure rate of 66 percent against the more common pathogens.

O'Brien, John R.; Hayden, Peter D.

1970-01-01

148

[Postauricular cutaneous mastoid fistula: a case report].  

PubMed

Infections which involve the middle ear mucosa may easily cause mastoiditis due to the relation between the middle ear space and mastoid cavity. Postauricular cutaneous mastoid fistula is a rare complication of chronic otitis media. While most of the simple mastoid fistulas tend to heal spontaneously with the treatment of chronic suppurative otitis media, cutaneous mastoid fistulas tend to heal very slowly, as the ingrowth of the skin surrounding the fistula is followed by necrosis or epithelization of the skin edges. In this article, we report a 46-year-old female case of automastoidectomy secondary to the chronic otitis and postauricular cutaneous mastoid fistula in the light of surgical closure technique. PMID:24010803

Müderris, Togay; Berçin, Sami; Sevil, Ergün; K?r??, Muzaffer

149

[Postoperative fistulas. How to close them].  

PubMed

Postoperative enterocutaneous fistulas are usually the result of an anastomotic leak. The likelihood of a postoperative fistula developing depends on concomitant diseases. An established gastrointestinal fistula is associated with considerable morbidity and mortality. Appreciable losses of fluid, protein and electrolytes often result in malnutrition, which has a negative impact on wound infection and the mental performance of the patient. Conservative treatment must aim to compensate these deficits as early as possible. Adequate amounts of energy (carbohydrates and fats) vitamins and trace elements must be ensured by replacement measures. In addition to appropriate drainage of the intra-abdominal focus and the use of antibiotics, treatment with octreotide (somatostatin analogues) may be considered. For conservative treatment, however, free intestinal transit distal to the fistula must be ensured. If an enterocutaneous fistula fails to heal within two or three months under conservative treatment, surgical management must be applied. PMID:12534059

Baumgartner, U

2002-11-01

150

Treatment of postparotidectomy fistulae with fibrin glue.  

PubMed

Although fistulae resulting from superficial parotidectomy represent a serious problem, there is still little consensus on the optimal treatment. Some suggest management by applying dressings, while others advise surgery. In recent years several other strategies have been proposed. In this manuscript, we present two cases of postparotidectomy fistulae treated by injection with fibrin tissue glue (Tissucol Duo 500, Baxter AG, Vienna, Austria). Furthermore, a review of the literature is presented. In both patients the fistulae completely healed within months without complications. A literature search revealed that this is the first time postparotidectomy fistulae were treated this way. We conclude that postparotidectomy fistulae can be effectively treated with fibrin glue. Moreover, this treatment is simple, safe and has no side effects. PMID:16696446

Zwaveling, Sander; Steenvoorde, Pascal; da Costa, Stephen Andrew

2006-01-01

151

A technique to deal with severe adhesions between the uterus and bladder or rectum in laparoscopic-assisted vaginal hysterectomy.  

PubMed

Severe adhesions between uterus and bladder or rectum, especially caused by endometriosis and multiple cesarean sections, remain a great challenge to surgeons in laparoscopic-assisted vaginal hysterectomy. Dense adhesions and anatomic variations cause difficulty in dissecting tissue planes, significant bleeding, lengthy operative time, and visceral injuries, especially an unrecognized thermal injury leading to late-onset fistulae or abscess. A modified technique, the combination of vaginal and laparoscopic approach with assistance of a Deaver retractor, is introduced in this article, which can achieve several advantages, including easily and safely dissecting tissue planes as close to the edge of adhesions as possible, avoidance of bladder or rectum injuries, less bleeding, shortened operative time, and minimized possibility of conversion to exploratory laparotomy if the surgeon is experienced in this technique. PMID:17980338

Cho, Fu-Nan

152

Routine Use of Setons for the Treatment of Anal Fistulae  

Microsoft Academic Search

Aim: Anal fistula is usually treated by either fistulotomy or fistulectomy. We described the routine use of setons to treat anal fistula without any surgery. Method: Forty-seven consecutive patients with diagnosed anal fistulae were treated using setons alone. Results: The median age of the patients was 41 (range: 18-70). Of the 47 patients, 15 had surgery previously for fistula and

S S Ngoi

153

Multiple intracranial dural arteriovenous fistula  

PubMed Central

Dural arteriovenous fistula (DAVF) is also known as dural arteriovenous malformation. Two forms of DAVF have been introduced, however, here we present an exceptional case of DAVF with unique origin and drainage. In this study, we present a rare case of multiple DAVFs in a 50 year old man with right parietal intraparenchymal hemorrhage. MRI showed two round right parieto-occipital masses with flow void intensity adjacent to superior sagittal sinus (SSS). Another pathology connected to SSS by an abnormal cortical vein was detected anterior to first lesion. This study showed that both DAVFs were simultaneously drained in SSS in our patient.

Rahmanian, Abdolkarim; Farrokhi, Majid R.; Alibai, Ehsan A.; Masoudi, Mohammad S.

2013-01-01

154

Aortoesophageal fistula in a child.  

PubMed

Aortoesophageal fistulae (AEF) are rare and are associated with very high mortality. Foreign body ingestions remain the commonest cause of AEF seen in children. However in a clinical setting of tuberculosis and massive upper GI bleed, an AEF secondary to tuberculosis should be kept in mind. An early strong clinical suspicion with good quality imaging and endoscopic evaluation and timely aggressive surgical intervention helps offer the best possible management for this life threatening disorder. Our case is a 10-year-old boy who presented to the pediatric emergency with massive bouts of haemetemesis and was investigated and managed by multidisciplinary team effort in the emergency setting. PMID:24019646

Panda, Shasanka Shekhar; Agarwala, Sandeep; Kabra, Sushil Kumar; Ray, Ruma; Sugandhi, Nidhi; Bhat, Abdus Sami; Lodha, Rakesh; Joshi, Prashant; Bisoi, Akshay Kumar; Arora, Arundeep; Gupta, Arun Kumar

2013-07-01

155

Aortoesophageal fistula in a child  

PubMed Central

Aortoesophageal fistulae (AEF) are rare and are associated with very high mortality. Foreign body ingestions remain the commonest cause of AEF seen in children. However in a clinical setting of tuberculosis and massive upper GI bleed, an AEF secondary to tuberculosis should be kept in mind. An early strong clinical suspicion with good quality imaging and endoscopic evaluation and timely aggressive surgical intervention helps offer the best possible management for this life threatening disorder. Our case is a 10-year-old boy who presented to the pediatric emergency with massive bouts of haemetemesis and was investigated and managed by multidisciplinary team effort in the emergency setting.

Panda, Shasanka Shekhar; Agarwala, Sandeep; Kabra, Sushil Kumar; Ray, Ruma; Sugandhi, Nidhi; Bhat, Abdus Sami; Lodha, Rakesh; Joshi, Prashant; Bisoi, Akshay Kumar; Arora, Arundeep; Gupta, Arun Kumar

2013-01-01

156

Multiple intracranial dural arteriovenous fistula.  

PubMed

Dural arteriovenous fistula (DAVF) is also known as dural arteriovenous malformation. Two forms of DAVF have been introduced, however, here we present an exceptional case of DAVF with unique origin and drainage. In this study, we present a rare case of multiple DAVFs in a 50 year old man with right parietal intraparenchymal hemorrhage. MRI showed two round right parieto-occipital masses with flow void intensity adjacent to superior sagittal sinus (SSS). Another pathology connected to SSS by an abnormal cortical vein was detected anterior to first lesion. This study showed that both DAVFs were simultaneously drained in SSS in our patient. PMID:24124437

Rahmanian, Abdolkarim; Farrokhi, Majid R; Alibai, Ehsan A; Masoudi, Mohammad S

2013-04-01

157

Vaginitis  

MedlinePLUS

... Date: 04/03/2013 Related A-Z Topics Bacterial Vaginosis Contraception and Birth Control Sexually Transmitted Diseases (STDs) All related topics NICHD News and Spotlights Division of Epidemiology, Statistics, and Prevention Research 2012 Annual Report Harnessing Research ...

158

Diagnosis and treatment of postsurgical synovial fistula of the knee.  

PubMed

With the exception of post-arthroscopy synovial fistulae formation, which generally heal without additional treatment, postsurgical synovial fistulae are relatively uncommon. We describe the development of synovial fistulae after three different surgical procedures: a biopsy, a high tibial osteotomy, and an anterior cruciate ligament reconstruction. With treatment tailored to the individual patient, the synovial fistulae can be cured by closing the opening between the knee joint and the fistula. PMID:22303760

van Kampen, A; Hinten, F

2011-12-01

159

Uteroenteric Fistula Resulting From Fibroid Expulsion After Uterine Fibroid Embolization: Case Report and Review of the Literature  

SciTech Connect

A 44-year-old woman underwent uncomplicated uterine fibroid embolization (UFE) for menstrual and bulk-related symptoms in an enlarged, myomatous uterus. After surgery, she spontaneously sloughed a large mass of fibroids that arrested in the cervical canal during passage. Four days after gynecological extraction, she developed copious vaginal discharge that contained enteric contents. Contrast-enhanced computed tomography (CT) demonstrated a fistula between the small bowel and the uterus. She subsequently underwent hysterectomy, left oophorectomy, and small-bowel resection. Her postoperative recovery was uneventful.

Gutierrez, Luis B., E-mail: lbgutier@stanford.edu [Stanford University, School of Medicine (United States); Bansal, Anshuman K., E-mail: abansal@mednet.ucla.edu [University of California at Los Angeles, Department of Radiology (United States); Hovsepian, David M., E-mail: hovsepian@stanford.edu [Stanford University, School of Medicine (United States)

2012-10-15

160

Protection against rat vaginal candidiasis by adoptive transfer of vaginal B lymphocytes.  

PubMed

Vulvovaginal candidiasis is a mucosal infection affecting many women, but the immune mechanisms operating against Candida albicans at the mucosal level remain unknown. A rat model was employed to further characterize the contribution of B and T cells to anti-Candida vaginal protection. Particularly, the protective role of vaginal B cells was studied by means of adoptive transfer of vaginal CD3(-) CD5(+) IgM(+) cells from Candida-immunized rats to naïve animals. This passive transfer of B cells resulted into a number of vaginal C. albicans CFU approximately 50% lower than their controls. Sorted CD3(-) CD5(+) IgM(+) vaginal B lymphocytes from Candida-infected rats proliferated in response to stimulation with an immunodominant mannoprotein (MP) antigen of the fungus. Importantly, anti-MP antibodies and antibody-secreting B cells were detected in the supernatant and cell cultures, respectively, of vaginal B lymphocytes from infected rats incubated in vitro with vaginal T cells and stimulated with MP. No such specific antibodies were found when using vaginal B cells from uninfected rats. Furthermore, inflammatory and anti-inflammatory cytokines, such as interleukin-2 (IL-2), IL-6 and IL-10, were found in the supernatant of vaginal B cells from infected rats. These data are evidence of a partial anti-Candida protective role of CD3(-) CD5(+) IgM(+) vaginal B lymphocytes in our experimental model. PMID:20402794

De Bernardis, Flavia; Santoni, Giorgio; Boccanera, Maria; Lucciarini, Roberta; Arancia, Silvia; Sandini, Silvia; Amantini, Consuelo; Cassone, Antonio

2010-03-08

161

Colocutaneous fistula secondary to amoebiasis  

PubMed Central

Here we present an interesting and extremely rare case of a 66 year old male who developed a colocutaneous fistula secondary to amoebiasis. The patient presented with an acute history of right lower abdominal pain, weight loss and a palpable mass. A CT scan demonstrated a fluid filled cavity in the right iliac fossa consistent with an appendiceal abscess which was drained under radiological guidance. However, following drainage his symptoms remained requiring open surgical drainage, and a controlled caecostomy was performed due to a small caecal perforation. Despite appropriate conservative therapy he failed to progress, and developed localised sepsis in the right iliac fossa with a colocutaneous fistula, requiring a formal right hemicolectomy. The histological examination confirmed the presence of abundant trophozoites of Entamoeba histolytica. We highlight the fact that in the modern age of immigration and long distance travel, it will become increasingly likely that the so-called ‘tropical’ diseases will present throughout the world. This case also highlights the need to keep an open mind in cases that do not progress as expected, and to react accordingly to any unusual developments.

Jones, Owain P.; Murphy, John A.; Hamid, Bushra N.; Vimalachandran, Dale

2010-01-01

162

Colocutaneous fistula secondary to amoebiasis.  

PubMed

Here we present an interesting and extremely rare case of a 66 year old male who developed a colocutaneous fistula secondary to amoebiasis. The patient presented with an acute history of right lower abdominal pain, weight loss and a palpable mass. A CT scan demonstrated a fluid filled cavity in the right iliac fossa consistent with an appendiceal abscess which was drained under radiological guidance. However, following drainage his symptoms remained requiring open surgical drainage, and a controlled caecostomy was performed due to a small caecal perforation. Despite appropriate conservative therapy he failed to progress, and developed localised sepsis in the right iliac fossa with a colocutaneous fistula, requiring a formal right hemicolectomy. The histological examination confirmed the presence of abundant trophozoites of Entamoeba histolytica.We highlight the fact that in the modern age of immigration and long distance travel, it will become increasingly likely that the so-called 'tropical' diseases will present throughout the world. This case also highlights the need to keep an open mind in cases that do not progress as expected, and to react accordingly to any unusual developments. PMID:22096684

Jones, Owain P; Murphy, John A; Hamid, Bushra N; Vimalachandran, Dale

2010-12-21

163

Saphenofemoral arteriovenous fistula as hemodialysis access  

PubMed Central

Background An upper limb arteriovenous (AV) fistula is the access of choice for haemodialysis (HD). There have been few reports of saphenofemoral AV fistulas (SFAVF) over the last 10-20 years because of previous suggestions of poor patencies and needling difficulties. Here, we describe our clinical experience with SFAVF. Methods SFAVFs were evaluated using the following variables: immediate results, early and late complications, intraoperative and postoperative complications (up to day 30), efficiency of the fistula after the onset of needling and complications associated to its use. Results Fifty-six SFAVF fistulas were created in 48 patients. Eight patients had two fistulas: 8 patent (16%), 10 transplanted (20%), 12 deaths (24%), 1 low flow (2%) and 20 thrombosis (39%) (first two months of preparation). One patient had severe hypotension during surgery, which caused thrombosis of the fistula, which was successfully thrombectomised, four thrombosed fistulae were successfully thrombectomised and revised on the first postoperative day. After 59 months of follow-up, primary patency was 44%. Conclusion SFAVF is an adequate alternative for patients without the possibility for other access in the upper limbs, allowing efficient dialysis with good long-term patency with a low complication rate.

2010-01-01

164

Optimized Dose Distribution of Gammamed Plus Vaginal Cylinders  

Microsoft Academic Search

Endometrial carcinoma is the most common malignancy arising in the female genital tract. Intracavitary vaginal cuff irradiation may be given alone or with external beam irradiation in patients determined to be at risk for locoregional recurrence. Vaginal cylinders are often used to deliver a brachytherapy dose to the vaginal apex and upper vagina or the entire vaginal surface in the

Sanjay S. Supe; T. K. Bijina; C. Varatharaj; B. Shwetha; T. Arunkumar; S. Sathiyan; K. M. Ganesh; M. Ravikumar

2009-01-01

165

Mullerian agenesis with vaginal vault prolapse following mechanically created neovagina.  

PubMed

A 21-year-old with mullerian agenesis, presented with vaginal mass. Previously, she developed a neovagina by the use of vaginal dilators. Examination revealed vaginal vault prolapse. She was surgically treated with vaginal vault suspension using a mesh. PMID:22578488

Burns, Eve; Naim, Masood; Badawy, Shawky Z A

2012-06-01

166

Magnetic resonance imaging of perianal fistulas.  

PubMed

Most cases of fistula-in-ano are nonspecific and result from inflammation of anal glands and crypts (cryptoglandular). The classification of cryptoglandular fistulas depends on the degree of involvement of the anal sphincter complex and determines the type of treatment. Studies have shown that preoperative MR imaging revealed important additional information compared with surgery alone and better predicts clinical outcome of patients with fistula-in-ano than initial surgical exploration. With the emergence of novel surgical treatments like MRI-guided surgery, laser, and adhesive treatments, MR imaging is a mainstay for preprocedural and intraoperative evaluation to ensure the adequacy of the procedure. PMID:16152739

Dwarkasing, Soendersing; Hussain, Shahid M; Krestin, Gabriel P

2005-08-01

167

Spinal Arteriovenous Epidural Fistula with Acute Paraplegia  

PubMed Central

Summary We report a case of a 68-year-old woman with an acute paraplegia due to venous congestion of the spinal cord caused by an exclusive epidural arteriovenous fistula. Diagnosed by MRI and selective spinal angiography the fistula was embolized during emergency treatment via transarterial access. Immediately after the intervention the paraplegia declined and the patient recovered completely. Epidural AV fistulae are a very rare and therefore relatively unknown cause of vascular myelopathy. They may require emergency management to avoid permanent neurological deficits.

Reul, J.; Braun, V.

2007-01-01

168

Broncho-pleuropericardial fistula complicating staphylococcal sepsis  

PubMed Central

This is a rare case of broncho-pleuropericardial fistula in a 12-year-old female who presented with fever, painful joint swelling, and pleural and pericardial effusion secondary to disseminated methicillin-sensitive Staphylococcus aureus infection. The pleural and pericardial effusion were drained, however, air leak was observed from both tubes and was synchronous with mechanical inspiration. A broncho-pleuropericardial fistula was suspected and confirmed with computed tomography. This case report demonstrated that disseminated S. aureus bacteremia could result in broncho-pleuropericardial fistula. The ability of disseminated staphylococcal infection to produce pnemopericardium should be added to the list of other complications associated with disseminated staphylococcal sepsis.

Arab, Abeer A.; Kattan, Maan A.; Alyafi, Walid A.; Alhashemi, Jamal A.

2011-01-01

169

Obstetric Fistula: Living With Incontinence and Shame  

PubMed Central

Over 2 million women worldwide have an obstetric fistula, with the majority of cases occurring in resource-poor countries. Afflicted women tend to be young, primiparous, impoverished, and have little or no access to medical care. Incontinent of urine and/or stool, these women become ostracized and shunned by their community. Most obstetric fistulas are surgically correctible, although surgical outcomes have been poorly studied. Programs that improve nutrition, delay the age of marriage, improve family planning, and increase access to maternal and obstetric care are necessary to prevent obstetric fistula.

Semere, Luwam; Nour, Nawal M

2008-01-01

170

Development of Indirect Cavernous Dural Arteriovenous Fistula after Trapping for Direct Carotid Cavernous Fistula  

PubMed Central

Summary A 60-year-old man with direct carotid cavernous fistula (CCF) due to a motor vehicle accident underwent internal carotid artery trapping following high-flow external carotid to internal carotid artery bypass (EC-IC bypass). Follow-up angiography revealed ipsilateral complex indirect cavernous arteriovenous fistula. Although the traumatic indirect CCF angioarchitecture differs from cavernous-sinus dural arteriovenous fistula (CS-DAVF), the present indirect fistula was similar to the latter. Complex indirect CCF can occur after treatment of direct CCF caused by severe head injury.

Yoshino, H.; Ishihara, H.; Oka, F.; Kato, S.; Suzuki, M.

2011-01-01

171

Vaginal rings for delivery of HIV microbicides  

PubMed Central

Following the successful development of long-acting steroid-releasing vaginal ring devices for the treatment of menopausal symptoms and contraception, there is now considerable interest in applying similar devices to the controlled release of microbicides against HIV. In this review article, the vaginal ring concept is first considered within the wider context of the early advances in controlled-release technology, before describing the various types of ring device available today. The remainder of the article highlights the key developments in HIV microbicide-releasing vaginal rings, with a particular focus on the dapivirine ring that is presently in late-stage clinical testing.

Malcolm, R Karl; Fetherston, Susan M; McCoy, Clare F; Boyd, Peter; Major, Ian

2012-01-01

172

[Local combined therapy of vaginal infections by nifuratel-nistatin].  

PubMed

A test included 40 women in the reproductive age with clinical symptoms of vaginitis and microbiological examination. They were treated by combined therapy of vaginal tablets of nifuratel, 500 mg and nistatin 200 000 i. u. during six days, after which they underwent gynaecological reexamination and repeated microbiological examination of vaginal and cervical smears. An analiysis of vaginal secretion found bacterial flora in 34 smears (65%), fungus (Candida albicans) in 15 (24%) and Trichomonas vaginalis in 7 (11%). Local vaginal therapy in vaginitis caused by Trichomonas vaginalis was successfull in all 7 patients, vaginitis caused by Candida albicans was successly treated in 14 (93%) patients. Bacterial vaginitis was cured in 29 (71%) patients during this tharapy. Local vaginal combined therapy of nifuratel and nistatin is eficient in patients with vaginitis caused by fungi and Trichomonas vaginalis too. PMID:20387731

Jahi?, Mahira; Bali?, Adem; Nurki?, Mahmud; Dragovi?, Jasmina; Adzajli?, Amela; Habibovi?, Amra; Mesali?, Lejla; Zigi?, Aza

2010-02-01

173

Efficacy and safety of Vitamin C vaginal tablets in the treatment of non-specific vaginitis  

Microsoft Academic Search

Methods: This was a randomised, double-blind, placebo-controlled study to evaluate the efficacy and safety of Vitamin C vaginal tablets (250mg) given once a day in patients suffering from non-specific vaginitis. The total length of the study was 20 days, including a treatment phase of 6 days. The primary end-point was the presence in the two groups of non-specific vaginitis 1

E. Eiko Petersen; Paola Magnani

2004-01-01

174

Treatment of pancreatic fistulas with somatostatin and total parenteral nutrition.  

PubMed

Nineteen pancreatic fistulas were treated with somatostatin (ST) and total parenteral nutrition (TPN). Five of the fistulas developed in an uninflamed pancreas, whereas 14 fistulas developed secondary to a necrotizing or chronic pancreatitis. Fistular output varied between 20 and 800 ml/day (median, 160 ml) during TPN before ST treatment; amylase concentration was 10,500-800,000 UI/l. Twelve of 16 (75%) fistulas were contaminated with bacteria. Thirteen of 19 (68%) fistulas closed after a median treatment of 7 (range, 2-14) days. Seven of eight fistulas with open drainage to the bowel healed, whereas only one of six with obstructed drainage closed. All of the uninfected fistulas and half of the infected fistulas closed. The findings suggest that somatostatin treatment speeds up the closure of pancreatic fistulas with open drainage to the bowel but is not beneficial when the intestinal drainage of the fistular region to the bowel is obstructed. PMID:2572046

Saari, A; Schröder, T; Kivilaakso, E; Kalima, T; Lempinen, M

1989-09-01

175

A Minimally Invasive Approach for Postoperative Pancreatic Fistula  

SciTech Connect

Pancreas fistula is a well-known and severe complication of pancreaticoduodenectomy. It is difficult to control with conservative therapy, inducing further complications and severe morbidity. Until now, re-operation has been the only way to resolve pancreatic fistula causing complete dehiscence of the pancreatic-enteric anastomosis (complete pancreatic fistula). Percutaneous transgastric fistula drainage is one of the treatments for pancreatic fistula. This procedure allows both pancreas juice drainage and anastomosis re-construction at the same time. This is effective and minimally invasive but difficult to adapt to a long or complicated fistula. In particular, dilatation of the main pancreatic duct is indispensable. This paper reports the successful resolution of a postoperative pancreatic fistula by a two-way-approach percutaneous transgastric fistula drainage procedure. Using a snare catheter from the fistula and a flexible guidewire from the transgastric puncture needle, it can be performed either with or without main pancreatic duct dilatation.

Yamazaki, Shintaro [Nihon University School of Medicine, 30-1 Ohyaguchi kamimachi, Itabashi-ku, Tokyo 173-8610, Third Department of Surgery (Japan)], E-mail: yamazaki-nmed@umin.ac.jp; Kuramoto, Kenmei [National Hospital Tokyo, Disaster Medical Center, Tokyo, Department of Radiology (Japan); Itoh, Yutaka [National Hospital Tokyo, Disaster Medical Center, Tokyo, Department of Surgery (Japan); Watanabe, Yoshika [Nihon University School of Medicine, 30-1 Ohyaguchi kamimachi, Itabashi-ku, Tokyo 173-8610, Third Department of Surgery (Japan); Ueda, Toshisada [National Hospital Tokyo, Disaster Medical Center, Tokyo, Department of Surgery (Japan)

2003-11-15

176

Effects of Electrosurgery and Vaginal Closure Technique on Postoperative Vaginal Cuff Dehiscence  

PubMed Central

Background and Objectives: The aim of our study is to evaluate the role of electrosurgery and vaginal closure technique in the development of postoperative vaginal cuff dehiscence. Methods: From prospective surgical databases, we identified 463 patients who underwent total laparoscopic hysterectomy (TLH) for benign disease and 147 patients who underwent laparoscopic-assisted vaginal hysterectomy (LAVH) for cancer. All TLHs and LAVHs were performed entirely by use of electrosurgery, including colpotomy. Colpotomy in the TLH group was performed with Harmonic Ace Curved Shears (Ethicon Endo-Surgery, Cincinnati, OH, USA), and in the LAVH group, it was performed with a monopolar electrosurgical pencil. The main surgical difference was vaginal cuff closure—laparoscopically in the TLH group and vaginally in the LAVH group. Results: Although patients in the LAVH group were at increased risk for poor healing (significantly older, higher body mass index, more medical comorbidities, higher blood loss, and longer operative time), there were no vaginal cuff dehiscences in the LAVH group compared with 17 vaginal cuff dehiscences (4%) in the TLH group (P = .02). Conclusion: It does not appear that the increased vaginal cuff dehiscence rate associated with TLH is due to electrosurgery; rather, it is due to the vaginal closure technique.

Kesterson, Joshua; Davies, Matthew; Green, Janis; Penezic, Lindsey; Vargas, Roberto; Harkins, Gerald

2013-01-01

177

CT in the diagnosis of enterovesical fistulae  

SciTech Connect

Enterovesical fistulae are difficult to demonstrate by conventional radiographic methods. Computed tomography (CT), a sensitive, noninvasive method of documenting the presence of such fistulae, is unique in its ability to outline the extravesical component of the primary disease process. Twenty enterovesical fistulae identified by CT were caused by diverticulitis (nine), carcinoma of the rectosigmoid (two), Crohn disease (three), gynecologic tumors (two), bladder cancer (one), cecal carcinoma (one), prostatic neoplasia (one), and appendiceal abscess (one). The CT findings included intravesical air (90%), passage of orally or rectally administered contrast medium into the bladder (20%), focal bladder-wall thickening (90%), thickening of adjacent bowel wall (85%), and an extraluminal mass that often contained air (75%). CT proved to be an important new method in the diagnosis of enterovesical fistulae.

Goldman, S.M.; Fishman, E.K.; Gatewood, O.M.B.; Jones, B.; Siegelman, S.S.

1985-06-01

178

Local repair of persistent tracheocutaneous fistulas.  

PubMed

Tracheocutaneous fistulas may persist after tracheostomy. Suture closure of the fistula may result in complications, including infection, wound dehiscence, and pneumomediastinum. We present a simplified and relatively safe technique to close persistent fistulas that may be performed under local anesthesia. A retrospective chart review was performed on 13 patients who were successfully treated, including 1 with incomplete closure that was successfully addressed by additional procedures. Our review included analysis of reported risk factors for persistence of tracheocutaneous fistulas: previous irradiation of the neck, an extended duration of cannulation, previous tracheostomies, obesity, and use of a Bjork flap or 4-flap epithelial-lined tracheostomy. All 13 patients in the study were found to have at least 1 of these risk factors. PMID:22032078

Khaja, Sobia F; Fletcher, Aaron M; Hoffman, Henry T

2011-09-01

179

Nursing considerations in patients with vaginitis.  

PubMed

Vaginitis is defined as an inflammation of the vagina. It can result in symptoms of any or all of the following: discharge, itching and pain, and often irritation or infection of the vulva. There is no specific cause for vaginitis, and many other conditions can cause the symptoms. Vaginitis is a distressing condition that affects many women of reproductive age and beyond, and encompasses candidiasis (also known as thrush), bacterial vaginosis, and trichomoniasis. It can occur in a single episode, or recur throughout a woman's lifetime. Some women will seek medical help, but many more self-treat with over-the-counter medications, suspecting the recurrence of Candida in particular. This article aims to explore the causes, signs and symptoms, and treatments of vaginitis to provide nurses with the necessary background information to feel more confident in dealing with women's health issues. PMID:20852467

Holloway, Debra

180

Vaginal Discharge: What's Normal, What's Not  

MedlinePLUS

... period Vaginal infections, such as bacterial vaginosis, candidiasis (yeast infection), and trichomoniasis are common causes of abnormal ... having sex, such as bacterial vaginosis or a yeast infection. If you notice any changes in your ...

181

Rulemaking History for OTC Vaginal Drug Products  

Center for Drug Evaluation (CDER)

... Correction [PDF], 3/21/1994, 59FR13284. Notice: Guidance on vaginal yeast infection topical drug product labeling [PDF], 7/16/1998, 63FR38412. ... More results from www.fda.gov/drugs/developmentapprovalprocess/developmentresources

182

Vaginitis: Questions to Discuss with Your Doctor  

MedlinePLUS

? Harvard Health Publications ? Order the Book ? Contact Us Sign up for our free e-mail newsletter, HEALTHbeat . ... the vaginal discharge ©2000–2006 President & Fellows of Harvard College Sign Up Now For HEALTH beat Our ...

183

Vaginal childbirth and pelvic floor disorders.  

PubMed

Childbirth is an important event in a woman's life. Vaginal childbirth is the most common mode of delivery and it has been associated with increased incidence of pelvic floor disorders later in life. In this article, the authors review and summarize current literature associating pelvic floor disorders with vaginal childbirth. Stress urinary incontinence and pelvic organ prolapse are strongly associated with vaginal childbirth and parity. The exact mechanism of injury associating vaginal delivery with pelvic floor disorders is not known, but is likely multifactorial, potentially including mechanical and neurovascular injury to the pelvic floor. Observational studies have identified certain obstetrical exposures as risk factors for pelvic floor disorders. These factors often coexist in clusters; hence, the isolated effect of these variables on the pelvic floor is difficult to study. PMID:23638782

Memon, Hafsa U; Handa, Victoria L

2013-05-01

184

Dural arteriovenous fistulae at the foramen magnum  

Microsoft Academic Search

s   Spinal dural arteriovenous fistulae (DAVF) affect predominantly levels of the lower thoracic and lumbar segments; only 13\\u000a cases have been reported of DAVF at the foramen magnum. We present three surgically treated patients with DAVF at the foramen\\u000a magnum. In none of our three patients could the site of the arteriovenous fistula be suspected from the clinical presentation.\\u000a The

Marcus H. T. Reinges; Armin Thron; Michael Mull; Beate C. Huffmann; Joachim M. Gilsbach

2001-01-01

185

Pancreatic-pleural fistula in chronic pancreatitis.  

PubMed

Pancreatic-pleural fistula is a rare condition and few data related to its diagnosis and treatment are available. A fistulous connection linking the pancreas with the pleura via the diaphragm or mediastinum through the retroperitoneal area is formed. We report on a case with pancreatic-pleural fistula at its early stages in an alcoholic male patient aged 45 years with known chronic pancreatitis. The operation by Roux-en-Y jejuno-pseudocystostomy was followed by chest tube drainage. PMID:22560825

Elkaoui, Hakim; Atoini, Fouad; Bouchentouf, Sidi Mohamed; El Omari, Fatima; Mahi, Mohamed; Ait Ali, Abdelmounaim; Bounaim, Ahmed; Sair, Khalid; Zentar, Aziz

2012-04-04

186

Giant Supratrigonal Vesicocervicovaginal Fistula - A Case Report  

PubMed Central

Vesicovaginal fistula (VVF) is prevalent in the developing world, with recent estimates suggesting that 2 million women live with fistula, mainly in sub-Saharan Africa and South Asia. VVF is associated with urogenital infections and ammonia dermatitis, and the psychosocial ramifications may be devastating, as women may be socially isolated from their families and community. VVF also remains a challenging condition for the gynecologic surgeon. We present a case of a giant supratrigonal VVF repaired using an abdominal (suprapubic) transperitoneal transvesical approach.

Bose, Chinmoy K; Basu, Amit; Kanjilal, Subir; Basu, Srabani

2005-01-01

187

Emerging therapies for postmenopausal vaginal atrophy.  

PubMed

Symptoms related to vaginal atrophy are a significant problem for postmenopausal women and estrogen has been the gold standard for its treatment. A number of recent reviews of vaginal estrogen products are available. This review will, therefore, focus on other products and potential products for this indication, including the tissue selective estrogen complex and selective estrogen receptor modulators. Additionally, lesser-studied approaches will be discussed. PMID:23434231

Pickar, James H

2013-02-22

188

Vaginal cysts causing tenesmus in a bitch.  

PubMed

An eight-year-old female border collie was referred with a two-month history of faecal tenesmus. Ultrasonography and radiology identified fluid-filled masses in the cranial vagina. The fluid was drained from the vaginal cysts via an episiotomy and the clinical signs resolved. Histological examination confirmed that the cysts were of urogenital origin. This is believed to be the first report of vaginal cysts causing faecal tenesmus in the dog. PMID:7474963

Cauvin, A; Sullivan, M; Harvey, M J; Thompson, H

1995-07-01

189

Effects of miphil, a new polycarbophil vaginal gel, in suspected bacterial vaginosis: a randomized study versus vaginal douche  

Microsoft Academic Search

Background: Vaginal pH is an important factor in maintaining a normal vaginal flora. Miphil (Mi) (Mipharm, Italy) is a new polycarbophil-based vaginal gel with high bioadhesivity and a long-lasting (>72 h) pH-lowering effect.Objective: To evaluate the effects on vaginal pH and odor of Mi in comparison with a vaginal douche (Lactacid) (L) in suspected bacterial vaginosis.Patients and methods: Thirty women

Massimo Milani; Bruno Molteni

2000-01-01

190

Treatment of refractory perianal fistulas with ligation of the intersphincteric fistula tract: preliminary results.  

PubMed

Several surgical options exist for management of fistula in ano. The goal of treatment is to achieve closure of the fistula while maintaining continence. Sphincter-sparing operations to close perianal fistulas include advancement flap, anal fistula plug, fibrin glue, and fistulectomy. Variable success rates from 30 to 80 per cent have been reported. Ligation of intersphincteric fistula tract (LIFT), first described in 2007, has a reported success rate from 40 to 94 per cent. The objective of this study was to study our results of the LIFT procedure for refractory perianal fistulas. We conducted a retrospective 18-month review of consecutive patients with refractory perianal disease treated with the LIFT procedure at an academic, tertiary, colorectal practice. All patients undergoing a LIFT procedure for anal fistula from August 2010 to August 2012 were included in the study. The primary end points were success rates at 1 month and 3 months. Secondary end points were postoperative complications and maintenance of continence. Twenty patients underwent LIFT procedures of whom nine had previously failed treatments. Mean age was 45 years and included 12 male and eight female patients. Success rate at 1 month was 70 per cent (14 patients) and at 3 months was 80 per cent (16 patients). Success rates for patients with previously failed attempts were 67 per cent at 1 month and 89 per cent at 3 months. Continence was maintained in 100 per cent of patients. Our data support the use of the LIFT procedure for refractory perirectal fistulas. PMID:23816007

Campbell, Michael L; Abboud, Elia Charbel; Dolberg, Michael E; Sanchez, Jaime E; Marcet, Jorge E; Rasheid, Sowsan H

2013-07-01

191

Rectal perforation, rectocutaneous fistula formation, and enterocutaneous fistula formation after pelvic trauma in a dog.  

PubMed

This report describes the management of rectal perforation, incision infection, implant failure, sepsis, osteonecrosis, and enterocutaneous fistula formation in a 3-year-old Yorkshire Terrier that was hit by a car. Rectal perforation from displaced pelvic fractures was suspected because of drainage from the incision, and clinical signs, and blood test results indicative of sepsis. Ilial and acetabular osteonecrosis from wound infection were treated with hemipelvectomy without pelvic limb amputation, and full limb function was regained. Primary repair of the rectal perforation and use of a muscle flap were unsuccessful, and a rectocutaneous fistula developed, but the rectum healed after colostomy for fecal diversion. An enterocutaneous fistula subsequently developed at the rectocutaneous fistula site, resulting in weight loss and continued drainage from the incision. Primary closure of the jejunal stoma, appropriate wound management, and nutritional support by enteral feeding resulted in eventual second-intention healing of the fistula and incision. PMID:7698940

Tobias, K M

1994-11-01

192

Primary and secondary adenocarcinomas associated with anal fistulae.  

PubMed

PURPOSE: The purpose of this study was to evaluate the clinical features, pathology, and etiology of adenocarcinoma in patients with anal fistulae. METHODS: We identified seven patients diagnosed with adenocarcinoma associated with anal fistulae from a retrospective chart review. RESULTS: Five patients were diagnosed with primary adenocarcinoma associated with anal fistulae. Two patients were diagnosed with secondary adenocarcinoma associated with anal fistulae originating from rectal cancer on the proximal side. The primary adenocarcinomas included cancers arising from long-standing anal fistulae fulfilling established diagnostic criteria in two patients, and cancer arising from short-duration anal fistulae in three patients. Excision of the fistula was performed based on the initial diagnosis of the anal fistula for all five patients. Increased suspicion of cancer was due to the existence of gelatinous material in the anal fistula in three patients and induration in the resected specimens in two patients. The etiologies of the secondary adenocarcinomas associated with anal fistulae included implantation in the anal fistula from rectal cancer and fistula formation originating due to the progression of rectal cancer. CONCLUSION: Anal fistulae are commonly seen in the coloproctology clinic, but special attention to similar conditions associated with malignant disease is needed. PMID:23722283

Yamada, Kyoko; Miyakura, Yasuyuki; Koinuma, Koji; Horie, Hisanaga; Lefor, Alan T; Yasuda, Yoshikazu; Fukushima, Noriyoshi; Oyama, Yusuke; Nemoto, Yuta; Azuma, Hiroshi

2013-05-31

193

Transperineal Management for Postoperative and Radiation Rectourethral Fistulas  

PubMed Central

Purpose The rectal sphincter preserving transperineal approach has been increasingly used successfully. We analyzed our experience with this surgical approach. A secondary aim was to evaluate the surgical outcome of energy ablative rectourethral fistulas without a concomitant interposition muscle flap. Materials and Methods We identified all patients with rectourethral fistula who underwent rectal sphincter preserving transperineal repair from 1998 to 2011. Re-approximation of the urethral mucosa, posterior anastomotic urethroplasty or partial/total prostatectomy with urethrovesical anastomosis was performed for urinary closure. The fistula cohort was divided into 2 groups, including postoperative and energy ablative fistulas, respectively. Success after perineal rectourethral fistula repair was defined as resolution after the first attempt at repair. Results A total of 23 patients underwent rectal sphincter preserving, transperineal rectourethral fistula repair. In the postoperative fistula cohort the fistula was successfully resolved in all 10 patients. A dartos interposition muscle flap was used in 2 of 10 patients. In the energy ablative cohort the fistula was successfully closed in 8 of 13 patients. An interposition muscle flap was not placed in 8 patients with an energy ablative fistula, of whom success was achieved in 5. Two of the 5 patients with an energy ablative fistula and a successful outcome without a concomitant interposition muscle flap had urinary extravasation, necessitating temporary catheterization. Conclusions Rectal sphincter preserving transperineal repair is a successful surgical method to repair postoperative and energy ablative rectourethral fistulas. An interposition muscle flap should be considered in the setting of energy ablative rectourethral fistulas to increase successful outcomes.

Voelzke, Bryan B.; McAninch, Jack W.; Breyer, Benjamin N.; Glass, Allison S.; Garcia-Aguilar, Julio

2013-01-01

194

Desflurane analgesia for vaginal delivery.  

PubMed

The use of subanaesthetic concentration of inhalational anaesthetic for vaginal delivery offers many advantages to the mother and newborn. Desflurane, with the characteristics of rapid onset and minimal metabolism, may provide better analgesia and safety for labour pain control. Eighty healthy parturients were randomly assigned to receive either desflurane 1.0-4.5% and oxygen (n = 40) or nitrous oxide 30-60% in oxygen (n = 40). Analgesia was assessed using a score from 0 (no relief) to 4+ (excellent analgesia), amnesia for the delivery, blood loss were recorded. Neonates were evaluated by Apgar scores and neurologic and adaptive capacity scores (NACS). Data were analyzed for statistical significance using Student's t-test or Chi-square when appropriate. Analgesia scores were similar for both groups with more amnesia in desflurane group (23% vs 0% P < 0.05). Blood loss did not differ significantly, 364 ml for the desflurane group and 335 ml for the nitrous oxide group. There were no significant differences for neonatal Apgar score at 1 min or at 5 min or the NACS at 2 hr or 24 hr between the two groups. We conclude that desflurane in subanaesthetic doses is safe and effective inhalation agent for normal delivery but might be associated with amnesia. PMID:7793195

Abboud, T K; Swart, F; Zhu, J; Donovan, M M; Peres Da Silva, E; Yakal, K

1995-02-01

195

Protection of macaques from vaginal SHIV challenge by vaginally delivered inhibitors of virus-cell fusion  

Microsoft Academic Search

Human immunodeficiency virus type 1 (HIV-1) continues to spread, principally by heterosexual sex, but no vaccine is available. Hence, alternative prevention methods are needed to supplement educational and behavioural-modification programmes. One such approach is a vaginal microbicide: the application of inhibitory compounds before intercourse. Here, we have evaluated the microbicide concept using the rhesus macaque `high dose' vaginal transmission model

Ronald S. Veazey; Per Johan Klasse; Susan M. Schader; Qinxue Hu; Thomas J. Ketas; Min Lu; Preston A. Marx; Jason Dufour; Richard J. Colonno; Robin J. Shattock; Martin S. Springer; John P. Moore

2005-01-01

196

Endovascular Management of Acute Bleeding Arterioenteric Fistulas  

SciTech Connect

The objective of this study was to review the outcome of endovascular transcatheter repair of emergent arterioenteric fistulas. Cases of abdominal arterioenteric fistulas (defined as a fistula between a major artery and the small intestine or colon, thus not the esophagus or stomach), diagnosed over the 3-year period between December 2002 and December 2005 at our institution, were retrospectively reviewed. Five patients with severe enteric bleeding underwent angiography and endovascular repair. Four presented primary arterioenteric fistulas, and one presented a secondary aortoenteric fistula. All had massive persistent bleeding with hypotension despite volume substitution and transfusion by the time of endovascular management. Outcome after treatment of these patients was investigated for major procedure-related complications, recurrence, reintervention, morbidity, and mortality. Mean follow-up time was 3 months (range, 1-6 months). All massive bleeding was controlled by occlusive balloon catheters. Four fistulas were successfully sealed with stent-grafts, resulting in a technical success rate of 80%. One patient was circulatory stabilized by endovascular management but needed immediate further open surgery. There were no procedure-related major complications. Mean hospital stay after the initial endovascular intervention was 19 days. Rebleeding occurred in four patients (80%) after a free interval of 2 weeks or longer. During the follow-up period three patients needed reintervention. The in-hospital mortality was 20% and the 30-day mortality was 40%. The midterm outcome was poor, due to comorbidities or rebleeding, with a mortality of 80% within 6 months. In conclusion, endovascular repair is an efficient and safe method to stabilize patients with life-threatening bleeding arterioenteric fistulas in the emergent episode. However, in this group of patients with severe comorbidities, the risk of rebleeding is high and further intervention must be considered. Patients with cancer may only need treatment for the acute bleeding episode, and an endovascular approach has the advantage of low morbidity.

Leonhardt, Henrik [Sahlgrenska University Hospital S, Department of Radiology (Sweden)], E-mail: henrik.leonhardt@vgregion.se; Mellander, Stefan [Sahlgrenska University Hospital S, Department of Vascular Surgery (Sweden); Snygg, Johan [Sahlgrenska University Hospital S, Department of Anesthesiology (Sweden); Loenn, Lars [Sahlgrenska University Hospital S, Department of Radiology (Sweden)

2008-05-15

197

Transvaginal approach for repair of rectovaginal fistulae complicating Crohn's disease.  

PubMed Central

The management of rectovaginal fistulae complicating Crohn's disease is difficult and often unsatisfactory. Between December 1983 and November 1988, 13 patients with Crohn's disease underwent repair of rectovaginal fistulae via a transvaginal approach. All patients had a diverting intestinal stoma either as part of the initial step in the staged management of intractable perianal disease or concurrent with the repair of the rectovaginal fistula. Each of the patients had low or mid septal fistulae; high fistulae generally are treated transabdominally and are not the focus of this discussion. Fistulae were eradicated in 12 of the 13 women and did not recur during the follow-up period, which averaged 50 months (range, 9 to 68 months). The only treatment failure was a patient who had a markedly diseased colon from the cecum to the rectum and a very low-lying fistula. It is concluded that a modified transvaginal approach is an effective method for repair of rectovaginal fistulae secondary to Crohn's disease.

Bauer, J J; Sher, M E; Jaffin, H; Present, D; Gelerent, I

1991-01-01

198

Unusual Cause of Orocutaneous Fistula in the Neck  

PubMed Central

A case of orocutaneous fistula secondary to submandibular sialolithiasis, which was masquerading clinically as branchial fistula is presented. This case highlights the importance of conducting fistulogram in the evaluation of discharging lesions in the neck.

Saha, Sudipta; Jha, Ashesh; Kaur, Navneet

2012-01-01

199

Oesophago-pleural fistula complicating a case of tuberculous pyopneumothorax.  

PubMed

The case of a 3-year-old girl who developed an oesophago-pleural fistula following tuberculous pyopneumothorax is described. She was successful managed followed by surgical closure of the fistula. PMID:6730011

Adeyemo, A O; Omole, C O

1984-03-01

200

Percutaneous transvenous embolisation of iatrogenic vertebral arteriovenous fistula  

Microsoft Academic Search

Two patients presented with vertebral arteriovenous fistulae following unintentional puncture of the vertebral artery. A percutaneous transvenous approach was used in both cases and the fistula was successfully embolised with microcoils. A complete cure was achieved in both patients.

S. Fukao; N. Hashimoto; K. Kazekawa; Y. Kaku

1995-01-01

201

Superficialization of arteriovenous fistulae employing minimally invasive liposuction.  

PubMed

Superficialization of arteriovenous fistulae allows for improved dialysis access allowing for prolonged utilization and more efficient dialysis treatment. Multiple methods are described for superficializing arteriovenous fistulae, and minimizing the surgical intervention is advantageous for patient recovery and potentially improved outcomes. We describe a novel technique of superficialization of an upper extremity arteriovenous fistula employing ultrasound-guided liposuction. This article describes the suction lipectomy technique and the tools necessary for superficialization of an upper extremity arteriovenous fistula. PMID:20598477

Causey, Marlin Wayne; Quan, Reagan; Hamawy, Adam; Singh, Niten

2010-11-01

202

Duodenocaval fistula as a result of a fish bone perforation.  

PubMed

Duodenocaval fistula is a rare and potentially lethal condition. We report a case of a 61-year-old female with a duodenocaval fistula resulting from a fish bone perforation of the duodenum who survived with conservative treatment. To our knowledge, this is the first reported case of a duodenocaval fistula caused by a fish bone. Additionally, besides revising the other possible etiologies for duodenocaval fistulae, we also discuss its diagnosis and treatment. PMID:20223621

Brandão, Daniel; Canedo, Alexandra; Maia, Miguel; Ferreira, Joana; Vaz, Guedes

2010-03-11

203

[Vulvo-vaginitis in pediatric age].  

PubMed

In pediatric gynecology, inflammatory vulvo-vaginitis are very common. Their diagnosis cannot be based either on the symptoms (itching or pain) or on the signs (leucoxanthorrhea) for these classifications are "non-specific". At the Consulting Room of pediatric gynecology of the Vittore Buzzi Hospital, 215 "non-specific" vulvo-vaginitis cases have been analyzed through bacteriological and microscopical examinations of vaginal secretions. The vaginal tampon resulted negative in 53% of the cases and positive in the remaining 47%. Comparing these results with microscopical examinations we obtain: 81.8% of sensibility, 77.4% of specificity, 87.8% of negative predictive value and 62.2% of positive predictive value. In particular, this last figure is influenced by the high number of false positives of the vaginal tampons, due to the growth "in vitro" of opportunist germs momentarily quiescent "in vivo". Thus it is useful to associated the microscopical examination (that will indicate all the cases in need of treatment) and the bacteriological examination (that will indicate the right cure). PMID:8133837

Beolchi, S; Brambilla, C; Roberti, P; Fadin, M; Facchini, M; Pansini, L; Maestri, L; Morandi, C

1993-11-01

204

Breech vaginal delivery at or near term.  

PubMed

Three percent to 4% of term fetuses will be breech at delivery. Evidence from randomized controlled trials has found a policy of planned cesarean section to be significantly better for the singleton fetus in breech presentation at term compared to a policy of planned vaginal birth. However, some women may wish to avoid cesarean section and for others, cesarean section may not be possible. We undertook this review to identify factors associated with higher and lower risk of adverse fetal or neonatal outcome at term during vaginal breech delivery. We searched MEDLINE from 1966 to 2002 using the search terms vaginal breech delivery and breech presentation and retrieved all relevant articles. We also reviewed personal references and reference lists of articles retrieved. Women who are older or who have a fetus that is either in footling presentation, has a hyperextended head or is estimated to weigh <2500 g or >4000 g may be at higher risk of adverse fetal outcome. Prolonged labor or not having an experienced clinician at vaginal breech birth may also increase the risk. Women with a fetus in breech presentation at term should be offered the option of delivery by planned cesarean section and should be informed that this will reduce their risk of adverse fetal or neonatal outcome. Practitioners should develop and maintain skills at vaginal breech delivery for those women not wishing or not able to be delivered by cesarean section. PMID:12641301

Tunde-Byass, Modupe O; Hannah, Mary E

2003-02-01

205

Effect of Vaginal Lubricants on Natural Fertility  

PubMed Central

Objective Over-the-counter vaginal lubricants have been shown to negatively affect in vitro sperm motility. The objective of this study was to estimate the effect of vaginal lubricant use during procreative intercourse on natural fertility. Methods Women aged 30–44 years with no history of infertility who had been trying to conceive for less than 3 months completed a baseline questionnaire on vaginal lubricant use. Subsequently, women kept a diary to record menstrual bleeding, intercourse, and vaginal lubricant use and conducted standardized pregnancy testing for up to 6 months. Diary data were used to determine the fertile window and delineate lubricant use during the fertile window. A proportional hazards model was used to estimate fecundability ratios with any lubricant use in the fertile window considered as a time-varying exposure. Results Of the 296 participants, 75 (25%) stated in their baseline questionnaire that they use vaginal lubricants while attempting to conceive. Based on daily diary data, 57% of women never used a lubricant, 29% occasionally used a lubricant, and 14% used a lubricant frequently. Women who used lubricants during the fertile window had similar fecundability to those women who did not use lubricants (fecundability ratio 1.05, 95% CI: 0.59, 1.85) after adjusting for age, partner race, and intercourse frequency in the fertile window. Conclusion Lubricants are commonly used by couples during procreative intercourse. Lubricant use during procreative intercourse does not appear to reduce the probability of conceiving.

Steiner, Anne Z.; Long, D. Leann; Tanner, Catherine; Herring, Amy H.

2012-01-01

206

[Clinical characteristics of aerobic vaginitis and its mixed infections.  

PubMed

OBJECTIVE: To investigate clinical characteristics of aerobic vaginitis (AV) and its mixed infections for diagnosis efficiently. METHODS: From April 2008 to December 2008, 516 patients with vaginitis treated in Tianjin Medical University General Hospital were enrolled in this study. AV, bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), trichomonal vaginitis (TV), and cytolytic vaginosis (CV) were diagnosed based on symptoms, sign and vaginal discharge examination. RESULTS: Among 516 cases, AV cases were found in 14.7% (76/516), and AV was common vaginal infection. AV mixed infections was diagnosed in 58% (44/76), including mixed with BV (45%, 20/44), mixed with VVC (30%, 13/44), and mixed with TV (25%, 11/44). Those common symptom of AV were yellow vaginal discharge (63%, 20/32), more vaginal discharge (44%, 14/32). Vaginal pH value was usually more than 4.5 (84%, 27/32). Vaginal cleanliness mainly was grade III - IV (88%, 28/32). Six cases with enterococcus faecium and 4 cases with streptococci were frequently isolated. The symptom and sign of mixed AV infection was atypical. CONCLUSIONS: Aerobic vaginitis is a common lower vaginal infection and easily mixed with other pathogens, especially with BV, VVC or TV. When patients were diagnosed with AV or other vaginal infection, it should be mentioned whether those patients have mixed vaginal infection or AV. PMID:21211421

Fan, Ai-Ping; Xue, Feng-Xia

2010-12-01

207

Rectovaginal fistula: management by intravenous feeding and surgical repair.  

PubMed

Two patients, each with a large rectovaginal fistula, were managed successfully by intravenous feeding and surgical repair of their fistulae. Intravenous feeding eliminated the need for food from the gastrointestinal tract, thus minimizing the fecal flow. Both fistulae healed following surgical repair. Neither patient required a diverting colostomy. PMID:32102

Piraka, H; Parsa, M H; Jahanmiri, F

208

Spinal dural arteriovenous fistula with perimesencephalic subarachnoid haemorrhage  

Microsoft Academic Search

A case is reported of a 66 year old woman presenting with perimesencephalic subarachnoid haemorrhage (SAH) which was caused by a spinal dural arteriovenous fistula at the C1 level. The fistula drained into the venous system of the posterior cranial fossa through a perimedullary vein. The bleeding was thought to result from venous hypertension induced by the fistula. This case

Hiroyuki Hashimoto; Jun-ichi Iida; Yasushi Shin; Yasuo Hironaka; Toshisuke Sakaki

2000-01-01

209

Repair of oronasal fistulas with human amniotic membrane in minipigs  

Microsoft Academic Search

We evaluated the use of multilayer human amniotic membrane (HAM) as a grafting material for the repair of mid-palate oronasal fistulas in seven Berlin minipigs. After two weeks, three animals had the fistulas repaired with multilayered HAM grafts, three had them repaired with a collagen-based dermal substitute (INTEGRA®, Integra Life Sciences, Plainsboro, NJ, USA), and one fistula was left untreated

Marco Rainer Kesting; Denys John Loeffelbein; Mariella Classen; Julia Slotta-Huspenina; Rafael Johannes Hasler; Frank Jacobsen; Kilian Kreutzer; Sammy Al-Benna; Klaus-Dietrich Wolff; Lars Steinstraesser

2010-01-01

210

Closure of orocutanous fistula using a pedicled expanded deltopectoral flap  

PubMed Central

Orocutaneous fistulas are associated with considerable morbidity. Closures of these fistulas are a challenge to the reconstructing surgeon. The aim of treatment is to provide healthy tissue to repair both the oral and cutaneous defects. The use of an expanded pedicled deltopectoral flap for the closure of an orocutaneous fistula in a patient who has undergone bilateral neck dissection and radiation is reported.

Balakrishnan, Chenicheri; Narasimhan, Kailash; Gursel, Tolga; Jackson, Ollie; Schaffner, Adam

2008-01-01

211

Surgical management of primary aortoesophageal fistula secondary to thoracic aneurysm  

Microsoft Academic Search

Aortoesophageal fistula, secondary to thoracic aortic aneurysm, is an uncommon cause of gastrointestinal bleeding that is uniformly fatal without surgical intervention. These may be primary fistulas, in cases of thoracic aortic aneurysm without previous repair, or secondary fistulas occurring after surgical repair of thoracic aortic aneurysm. Surgical treatment has been successful in a small number of cases of primary aortoesophageal

Michael J Reardon; Robert J Brewer; Scott A LeMaire; John C Baldwin; Hazim J Safi

2000-01-01

212

Endoscopic closure of recurrent tracheoesophageal fistula using tisseel  

Microsoft Academic Search

The author reports on two patients who presented with recurrent tracheoesophageal fistula. They were treated with the endoscopic application of fibrin sealant (Tisseel) directly to the fistula tract. The technique may require multiple applications before complete fistula closure is achieved. The procedure is associated with low morbidity and may eliminate the need for a second thoracotomy.

Nathan E. Wiseman

1995-01-01

213

Delayed Presentation of a Tracheoesophageal Fistula After Blunt Chest Trauma  

Microsoft Academic Search

Traumatic tracheoesophageal fistula is an uncommon injury after blunt chest injury. Rapid deceleration against the steering wheel during a high-speed motor vehicle crash is the usual mechanism of injury. Previous reports document few cases of delayed diagnosis and repair of tracheoesophageal fistula. We report a case of delayed diagnosis of tracheoesophageal fistula more than 20 years after the original trauma

Sharon M Weber; Michael J Schurr; John R Pellett

1996-01-01

214

Aorto-caval and ilio-iliac arteriovenous fistulae  

Microsoft Academic Search

Background: To determine optimal management of major abdominal arteriovenous fistulae and define factors affecting outcome.Methods: We reviewed clinical data of 18 patients, 16 males and 2 females, who underwent repair of major abdominal arteriovenous fistulae between 1970 and 1997.Results: Sixteen patients had primary fistula, caused by rupture of an atherosclerotic aortic or aortoiliac aneurysm into the inferior vena cava (IVC),

P. Michael Davis; Peter Gloviczki; Kenneth J Cherry; Barbara J Toomey; Anthony W Stanson; Thomas C Bower; John W Hallett

1998-01-01

215

Successful arterial embolization of arteriovenous fistula in the portal circulation  

Microsoft Academic Search

We successfully performed arterial embolization of an arteriovenous fistula between the left gastric artery and vein. The increased blood flow in the portal vein via the left gastric vein and the arteriovenous fistula induced severe portal hypertension. After obliteration of the left gastric artery, the arteriovenous fistula was not opacified on angiography and the portal hypertension improved.

Tetsuo Nakamura; Yoshinori Isobe; Eiko Ueno; Yumi Kondoh; Izumi Yoshida; Hiroshi Obata

1992-01-01

216

Iatrogenic mammary arteriovenous fistula caused by sternal wire  

Microsoft Academic Search

Internal mammary arteriovenous fistulas are a rare complication of sternotomy. We present a case of a 64-year-old woman with a poststernotomy fistula between the left mammary vein and artery with formation of a pseudoaneurysm with subcutaneous extension. We describe the different imaging techniques that led to the diagnosis and the resolution of the fistula via endovascular embolization.

Jacobo Silva; José Gonzalez-Santos; Mar??a Pérez; Manuel Ruiz; José L. Vallejo

1998-01-01

217

Vaginal T lymphocyte population kinetics during experimental vaginal candidosis: evidence for a possible role of CD8+ T cells in protection against vaginal candidosis  

PubMed Central

Vaginal candidosis represents a significant health problem to women of childbearing age worldwide. It has been postulated that localized T cells play a role in protection against vaginal candidosis. In an attempt to evaluate the role of vaginal T cells in protection against vaginal candidosis, T cell population kinetics was evaluated using an oestrogen-dependent vaginal candidosis murine model. Vaginal T lymphocytes were isolated at different time points post C. albicans inoculation, viable cells were enumerated, phenotypically analysed for the expression of CD3, CD4 and CD8 T cell markers and absolute numbers of T cell subsets were calculated. Oestrogen-induced persistence of vaginal candidosis resulted in a significant increase in the total number of vaginal lymphocytes within 24–48 h post infection; increased vaginal lymphocyte numbers persisted throughout the infection period. The number of CD3+ T cells dramatically increased following C. albicans administration and was maintained at high levels throughout the infection period. The majority of CD3+ T cells were of the CD8+ type; however, considerable numbers of both CD4+ T cells and CD4+CD8+ T cells were also observed throughout the infection period. The considerable and persistent increase in vaginal T cell numbers in general and that of CD8+ T cells in particular are evidence of the possible role played by localized T cells in protection against vaginal candidosis.

GHALEB, M; HAMAD, M; ABU-ELTEEN, K H

2003-01-01

218

Gastrostomy Tube Insertion into Intestinal-Cutaneous Tract Fistulas Is a New Technique to Improve Fistula Control  

Microsoft Academic Search

Background: The management of gastrointestinal-cutaneous fistulas may be complicated by the difficulty in obtaining adequate control of the fistula tract. This study describes a new method to obtain better fistula control utilizing a semi-rigid stent in the form of a gastrostomy tube. Methods: Consecutive patients with intestinal-cutaneous fistulas of at least 3 weeks duration and treated by the new technique

Jorma Halttunen; Jukka Sirén; Eero Kivilaakso

2003-01-01

219

A Novel Technique for Anterior Vaginal Wall Prolapse Repair: Anterior Vaginal Wall Darn  

PubMed Central

Aim. The aim of this study is to introduce a new technique, anterior vaginal wall darn (AVWD), which has not been used before to repair the anterior vaginal wall prolapse, a common problem among women. Materials and Methods. Forty-five women suffering from anterior vaginal wall prolapse were operated on with a new technique. The anterior vaginal wall was detached by sharp and blunt dissection via an incision beginning from the 1?cm proximal aspect of the external meatus extending to the vaginal apex, and the space between the tissues that attach the lateral walls of the vagina to the arcus tendineus fascia pelvis (ATFP) was then darned. Preoperation and early postoperation evaluations of the patients were conducted and summarized. Results. Data were collected six months after operation. Cough stress test (CST), Pelvic Organ Prolapse Quantification (POP-Q) evaluation, Incontinence Impact Questionnaire (IIQ-7), and Urogenital Distress Inventory (UDI-6) scores indicated recovery. According to the early postoperation results, all patients were satisfied with the operation. No vaginal mucosal erosion or any other complications were detected. Conclusion. In this initial series, our short-term results suggested that patients with grade II-III anterior vaginal wall prolapsus might be treated successfully with the AVWD method.

Kose, Osman; Saglam, Hasan S.; Kumsar, Sukru; Budak, Salih; Adsan, Oztug

2013-01-01

220

Vaginal delivery through annular placenta -- case report.  

PubMed

Annular placenta is an extremely rare morphological type of human placenta. It is commonly related to placental vessel abnormalities frequently causing antenatal and postnatal hemorrhage and operative delivery. Gravida 4 para 1 had an uneventful course of pregnancy and normal vaginal delivery followed by moderate postpartum hemorrhage. Hemorrhage was found to be local in origin but the placenta was annular in shape and the newborn was delivered through one of the openings. Annular placenta was not recognized before delivery. Its implantation site was in the lower uterine segment but high enough to allow the passage of the fetus through its annular defect and vaginal birth. To our knowledge, this is a first report of annular placenta ending in normal vaginal delivery. PMID:23630149

Živkovi?, Nikica; Krezo, Stipe; Matijevi?, Ratko; Živkovi?, Kresimir

2013-04-01

221

Vaginal delivery through annular placenta - case report  

PubMed Central

Annular placenta is an extremely rare morphological type of human placenta. It is commonly related to placental vessel abnormalities frequently causing antenatal and postnatal hemorrhage and operative delivery. Gravida 4 para 1 had an uneventful course of pregnancy and normal vaginal delivery followed by moderate postpartum hemorrhage. Hemorrhage was found to be local in origin but the placenta was annular in shape and the newborn was delivered through one of the openings. Annular placenta was not recognized before delivery. Its implantation site was in the lower uterine segment but high enough to allow the passage of the fetus through its annular defect and vaginal birth. To our knowledge, this is a first report of annular placenta ending in normal vaginal delivery.

Zivkovic, Nikica; Krezo, Stipe; Matijevic, Ratko; Zivkovic, Kresimir

2013-01-01

222

Operative vaginal delivery: current trends in obstetrics.  

PubMed

After centuries of use in obstetrics, have forceps and vacuum deliveries become a dying art? Contemporary trends in operative vaginal delivery show increasing numbers of vacuum deliveries and decreasing numbers of forceps deliveries worldwide. Primary drivers of such trends include concerns over neonatal and maternal safety as well as fewer clinicians skilled in forcep use. Current literature reports a comparable efficacy rate for the two instruments, as well as a decrease in maternal morbidity compared with cesarean section. It has also been suggested that the neonatal morbidity once associated with operative vaginal delivery may actually be a function of an abnormal labor process itself, rather than a consequence of an operative vaginal intervention. Both the American College and the Royal College of Obstetricians and Gynecologists continue to support the use of both vacuum and forceps and strongly encourage residency programs to incorporate the teaching of these skills into their curricula. PMID:19072477

Goetzinger, Katherine R; Macones, George A

2008-05-01

223

Suprapubic transvesical laparoendoscopic single-site surgery for vesicovaginal fistula repair: a case report.  

PubMed

Some minimally invasive techniques have been introduced to decrease morbidity related to standard laparoscopic procedures. One such approach is laparoendoscopic single-site surgery (LESS), which can also be applied for transvesical surgery. The aim of the study was to present our initial clinical experience of using this technique for transvesical vesicovaginal fistula (VVF) repair. In August 2011, we carried out the LESS repair of a 3-mm in diameter vesicovaginal fistula on a 72-year-old woman, who failed the conservative treatment with Foley placement. The procedure was performed transvesically (percutaneous intraluminal approach) with a single-port device (4-channel, TriPort+, Olympus Winter&IBE GMBH) via a 1.5-cm incision made 2 cm above the pubic symphysis. A standard 10-mm optic and straight laparoscopic instruments were used. The fistulous tract was dissected and partially excised. The bladder and vaginal wall defects were closed in two layers with running absorbable V-Loc (Covidien, Norwalk, CT, USA) suture. Ureteral catheters were left for 5 days and the Foley catheter for 14 days. The operative time was 170 min. The blood loss was minimal. No complications were observed. The postoperative period was uneventful. During a 6-month follow-up the patient reported no involuntary discharge of urine into the vagina. Diagnostic scans revealed no presence of VVF and laboratory examination results were all within the normal range. Although substantial development of the instruments and skills is needed, the transvesical LESS vesicovaginal fistula repair appeared to be feasible and safe. Nevertheless, further experience and observations are necessary. PMID:23362433

Roslan, Marek; Markuszewski, Marcin M; Bagi?ska, Joanna; Krajka, Kazimierz

2012-09-29

224

Hormone Replacement Therapy: Can It Cause Vaginal Bleeding?  

MedlinePLUS

... may be reprinted for personal, noncommercial use only. Hormone replacement therapy: Cause of vaginal bleeding? By Mayo Clinic staff ... share your e-mail address Sign up Question Hormone replacement therapy: Cause of vaginal bleeding? I'm taking hormone ...

225

Efficacy and Tolerability of Fitostimoline (Vaginal Cream, Ovules, and Vaginal Washing) and of Benzydamine Hydrochloride (Tantum Rosa Vaginal Cream and Vaginal Washing) in the Topical Treatment of Symptoms of Bacterial Vaginosis  

PubMed Central

Two hundred and 91 patients showing signs and symptoms of bacterial vaginosis (BV) were randomized to receive topical treatment with Fitostimoline (vaginal cream and vaginal ovules + vaginal washing) or benzydamine hydrochloride (vaginal cream + vaginal washing) for 7 days. Signs (leucorrhoea, erythema, oedema, and erosion) and symptoms (burning, pain, itching, vaginal dryness, dyspareunia, and dysuria) (scored 0–3) were evaluated at baseline and at the end of treatment; the total symptoms score (TSS) was also calculated. In 125 patients, a bacterial vaginosis was confirmed by vaginal swab test. The primary efficacy variable analysis, that is, the percentage of patients with therapeutic success (almost complete disappearance of signs and symptoms), demonstrated that Fitostimoline ovules and vaginal cream were therapeutically equivalent and that pooled Fitostimoline treatment was not inferior to benzydamine hydrochloride. All the treatments were well tolerated, with only minor local adverse events infrequently reported. The results of this study confirmed that gynaecological Fitostimoline is a safe and effective topical treatment for BV.

Boselli, F.; Petrella, E.; Campedelli, A.; Muzi, M.; Rullo, V.; Ascione, L.; Papa, R.; Saponati, G.

2012-01-01

226

Vaginal cuff dehiscence with adnexal mass evisceration after abdominal hysterectomy  

PubMed Central

INTRODUCTION More commonly, a vaginal cuff dehiscence is a complication of robotic or laparoscopic hysterectomy while dehiscence is less commonly observed following total abdominal or vaginal hysterectomies. PRESENTATION OF CASE Three years after an uncomplicated total abdominal hysterectomy for fibroid uterus, a 50 year old female with a known, large adnexal mass presented with vaginal cuff dehiscence and prolapse of the adnexal mass through the vaginal cuff. DISCUSSION We discuss surgical risk factors including route of hysterectomy, method of colpotomy and vaginal cuff closure as contributing factors for vaginal cuff dehiscence in our patient. CONCLUSION Any large pelvic mass that may potentially exert pressure necrosis on the vaginal cuff, even remote from hysterectomy may result a vaginal cuff dehiscence. Emergent surgical intervention is warranted.

Nguyen, My-Linh T.; Anyikam, Adanna L.; Paolucci, Michele

2013-01-01

227

Intraoral cheek fistulae: a refined technique.  

PubMed

Taste reactivity testing (TRT), which entails infusing a solution into the oral cavity of subjects, is used across a wide range of studies. For laboratories inexperienced in the conventional technique of implanting cheek fistulae, the surgery can be problematic for both the subjects and the experimenter. We have proposed a refined method for fistulae implantation that is less invasive, thereby reducing the pain and distress of the animals. Using this refined technique, we were able to replicate the findings of previous TRT studies, namely that a high dose of lithium chloride produces an increase in aversive and a decrease in ingestive orofacial and somatic responses. Using indices of health, we demonstrate that unlike animals with the conventional method of fistulae implantation, subjects that receive the refined technique regain their pre-surgery body weights rapidly and show no physical signs of discomfort. Additional advantages of the refined technique are discussed. PMID:17018216

Hintiryan, Houri; Hayes, UnJa L; Chambers, Kathleen C

2006-10-01

228

Thoracic endovascular aortic repair for aortobronchial fistula.  

PubMed

The objective was to provide a systematic review of outcomes of thoracic endovascular aortic repair for aortobronchial fistula. A literature search identified 134 patients. The technical success rate was 93.2%. The overall 30-day mortality was 5.9%. After a mean follow-up of 17.4 months, the aortic-related mortality was 14.3%. Recurrence of the aortobronchial fistula was observed in 11.1% of the patients. Thoracic endovascular aortic repair of aortobronchial fistulas appears to be a viable alternative with excellent short-term results. Strict follow-up and aggressive adjunctive measures are needed to treat ongoing infection to prevent late related mortality. PMID:23916807

Canaud, Ludovic; Ozdemir, Baris Ata; Bahia, Sandeep; Hinchliffe, Robert; Loftus, Ian; Thompson, Matt

2013-08-02

229

Spontaneous carotid cavernous fistula complicating pregnancy.  

PubMed

Carotid cavernous fistula is a well-documented but rare condition in pregnancy, about which there are a limited number of reports in the literature. We report such a case in a 41-year-old woman presenting with right-sided headache, proptosis, and diplopia at 37 weeks of gestation. She was subsequently diagnosed to have carotid cavernous fistula based on angiography. Embolisation was performed in the postpartum period. Carotid cavernous fistula has the potential of serious morbidity including visual loss and intracranial haemorrhage. It can be treated effectively by endovascular embolisation, which confers a good prognosis. Although headache is a common complaint during pregnancy, obstetrician should be aware of this condition if the clinical presentation is suspicious. PMID:23732431

Yeung, S W; Suen, Stephen S H; Yu, Simon C H; Lao, Terence T; Leung, T Y; Lau, T K

2013-06-01

230

Bilateral Congenital Lacrimal Fistula in Down Syndrome  

PubMed Central

Congenital lacrimal fistulae are rare in Down syndrome and bilateral presentation is very unusual. It can be associated with nasolacrimal duct obstruction. We report a 3-year-old female with Down syndrome who presented with watering and discharge from both eyes and bilateral fistulous openings present inferonasal to the medial canthus. Upon examination, the lacrimal sac regurgitation test was positive on both sides. Our case report documents a distinctive case of bilateral congenital lacrimal fistulae in association with Down syndrome. It was managed successfully by primary fistulectomy and nasolacrimal duct probing.

Singh, Manpreet; Singh, Usha

2013-01-01

231

Spinal dural arteriovenous fistulas: a review.  

PubMed

Spinal dural arteriovenous fistulas (SDAVF) are a rare pathologic entity with a diverse and often misleading clinical presentation. While digital subtraction spinal angiography remains the gold standard, recent advances in noninvasive vascular imaging have improved the diagnosis of SDAVF. As this condition can result in permanent spinal cord injury, all patients require treatment, which consists of surgical or endovascular occlusion of the fistula. Failure to recognize and treat SDAVF in a timely fashion can result in irreversible neurologic disability, including myelopathy, lower extremity weakness and bowel, bladder and sexual dysfunction. This article reviews the clinical features, pathogenesis, radiographic features and current treatment strategies for these complex lesions. PMID:23666862

Marcus, Joshua; Schwarz, Justin; Singh, I Paul; Sigounas, Dimitri; Knopman, Jared; Gobin, Y Pierre; Patsalides, Athos

2013-07-01

232

Metabolic consequences of patients with gastrointestinal fistulas  

Microsoft Academic Search

Methods and Materials  The historical highlights of the management of fistulas of the gastrointestinal tract during the past century are presented\\u000a briefly, together with the significant lessons learned from the studies published in the literature.\\u000a \\u000a \\u000a \\u000a \\u000a Discussion  The evolution from predominantly operative or technical approaches to comprehensive multidisciplinary management of metabolic\\u000a and nutritional support, which are essential to optimal fistula closure, and morbidity

S. J. Dudrick; L. Panait

2011-01-01

233

Atrioesophageal fistula after cryoballoon pulmonary vein isolation.  

PubMed

The risk of atrioesophageal fistula after cryoballoon pulmonary vein isolation is thought to be much lower than after radiofrequency ablation, seeing that no data exist on this complication so far. We report for the first time on the occurrence of an atrioesophageal fistula 4 weeks after cryoballoon ablation at the site of the left inferior pulmonary vein. We suggest that even when using cryothermal ablation technique, an imaging modality to assess the proximity of esophagus and left atrium should be routinely performed to avoid this fatal complication. PMID:22486804

Stöckigt, Florian; Schrickel, Jan W; Andrié, René; Lickfett, Lars

2012-04-09

234

Tracheostomy Tube-induced Tracheoesophageal Fistula.  

PubMed

Tracheostomy is one of the most common elective surgical procedures performed in critically ill patients. The complications of tracheostomy may be categorized on the basis of duration from the procedure: early-intraoperative, medium-early postoperative, and late postoperative. Tracheoeosphageal fistula is one of the known late complications of tracheostomy. Injury to the tracheal wall can occur because of high cuff pressure or direct mechanical trauma from the tracheostomy tube. We report a case of tracheoeosphageal fistula caused by a cuffless tracheostomy tube that was managed by an endobronchial stent. PMID:23168551

Chua, Ai Ping; Dalal, Bhavin; Mehta, Atul C

2009-07-01

235

Preterm Singleton Breech in North Jordan: Vaginal versus Abdominal Delivery  

Microsoft Academic Search

The safety of vaginal birth for singleton preterm breech has not often been addressed before. We retrospectively compared the perinatal outcome of two groups of preterm breech delivery. Sixty-six patients delivered vaginally and 32 delivered abdominally between 26 and 36 completed weeks. Vaginal delivery was allowed under the same protocol for singleton breech delivery at term. Both groups had similar

Saeed Ziadeh; Adel T. Abu-Heija; Ellias El-Sunna; Mohammad F. El-Jallad; Ahmad Shatnawi; A. Obeidat

1997-01-01

236

Bacterial vaginosis and vaginal fluid defensins during pregnancy  

Microsoft Academic Search

Objective: The purpose of this study was to examine the association between Gram stain findings of vaginal fluid and the concentration of vaginal fluid neutrophil defensins. Study Design: Vaginal fluid specimens obtained from 749 women at 24 to 29 weeks of gestation were tested for bacterial vaginosis and assayed for neutrophil defensins. Bacterial vaginosis was studied as a categoric variable

Rukmini B. Balu; David A. Savitz; Cande V. Ananth; Katherine E. Hartmann; William C. Miller; John M. Thorp; R. Phillips Heine

2002-01-01

237

Traumatic sinolacrimocutaneous fistula managed with endonasal dacryocystorhinostomy and anterior ethmoidectomy.  

PubMed

A 31-year-old man with epiphora and mucous discharge from a traumatic lacrimal fistula underwent a computed tomographic dacryocystogram, revealing a fistula extending from the anterior ethmoid air cells through the lacrimal sac to the overlying skin with coexisting nasolacrimal duct obstruction. Endoscopic dacryocystorhinostomy enabled complete marsupialization of the lacrimal sac and agger nasi air cell, removing the tract between these structures. Simultaneous probing of the common canaliculus and fistula tract under direct visualization allowed the identification of the internal fistula origin in relation to the internal ostium on the lateral sac wall. The fistula was excised with a trephine over a guide wire via an external approach. Use of the endoscopic technique for excision of acquired lacrimal fistulas may be especially helpful in cases with coexisting nasolacrimal duct obstruction where the fistula extends to the sinus cavity or suspected foreign bodies. PMID:23044945

Shams, Pari N; Selva, Dinesh

2012-10-01

238

Ligation of intersphincteric fistula tract and its modification: Results from treatment of complex fistula  

PubMed Central

AIM: To compare healing rates between intersphincteric fistula tract (LIFT) and LIFT plus partial fistulectomy procedures. METHODS: A study of complex fistula-in-ano patients was carried out from 1st March 2010 to 31th January 2012. All operations were done by colorectal surgeons at a referral center in a Ministry of Public Health hospital. Data collected included patients’ demographic details, fistula type determined by endorectal-ultrasonography, preoperative and postoperative continence status, previous operations, time between diagnosis of fistula-in-ano and operation, type of surgery, healing rates, recurrence rates, and types of failure examined by endorectal-ultrasosnography, re-operation in recurrence or failure cases, and complications. RESULTS: The study involved 41 patients whose average age was 40.78 ± 11.84 years (range: 21-71 years). The major fistula type was high-transsphincteric type fistula. The median follow-up period was 24 wk. The overall success rate was 83%: in the LIFT (Ligation intersphincteric fistula tract) group the success rate was 81% and in the LIFT plus (LIFT with partial coreout fistulectomy) group it was 85% (P = 0.529). The median wound-healing time was 4 wk in both groups (P = 0.262). The median time to recurrence was 12 wk. Neither group had incontinence (Wexner incontinence score-0) and the difference in healing rates between the two groups was not statistically significant. CONCLUSION: There was no difference in results between LIFT and LIFT plus operations. The LIFT procedure is a good option for maintaining continence in management of fistula-in-ano.

Sirikurnpiboon, Siripong; Awapittaya, Burin; Jivapaisarnpong, Paiboon

2013-01-01

239

Sexual abuse of children as seen at Kenyatta National Hospital.  

PubMed

A retrospective study of 21 sexually abused children admitted to the Kenyatta National Hospital, Nairobi, Kenya, between January 1984 and December 1985 is presented. The peak incidence of sexual abuse was in the age group of 10-15 years (38.1%) followed by the 5-9 years age group (28.6%). Strangers and people familiar to the child were equally implicated as assailants. Fourteen out of the twenty one (66.7%) victims, presented with injuries ranging from perineal tears (19%), vaginal tears (19%), recto-vaginal fistulae (RVP) (4.8%) and vesico-vaginal-fistulae (VVF) and abdominal haematoma (4.8%). The victims presented to hospital within two days of the event usually accompanied by their mothers. PMID:1396187

Nduati, R W; Muita, J W

1992-07-01

240

Protocols for vaginal inoculation and sample collection in the experimental mouse model of Candida vaginitis.  

PubMed

Vulvovaginal candidiasis (VVC), caused by Candida species, is a fungal infection of the lower female genital tract that affects approximately 75% of otherwise healthy women during their reproductive years. Predisposing factors include antibiotic usage, uncontrolled diabetes and disturbance in reproductive hormone levels due to pregnancy, oral contraceptives or hormone replacement therapies. Recurrent VVC (RVVC), defined as three or more episodes per year, affects a separate 5 to 8% of women with no predisposing factors. An experimental mouse model of VVC has been established and used to study the pathogenesis and mucosal host response to Candida. This model has also been employed to test potential antifungal therapies in vivo. The model requires that the animals be maintained in a state of pseudoestrus for optimal Candida colonization/infection. Under such conditions, inoculated animals will have detectable vaginal fungal burden for weeks to months. Past studies show an extremely high parallel between the animal model and human infection relative to immunological and physiological properties. Differences, however, include a lack of Candida as normal vaginal flora and a neutral vaginal pH in the mice. Here, we demonstrate a series of key methods in the mouse vaginitis model that include vaginal inoculation, rapid collection of vaginal specimens, assessment of vaginal fungal burden, and tissue preparations for cellular extraction/isolation. This is followed by representative results for constituents of vaginal lavage fluid, fungal burden, and draining lymph node leukocyte yields. With the use of anesthetics, lavage samples can be collected at multiple time points on the same mice for longitudinal evaluation of infection/colonization. Furthermore, this model requires no immunosuppressive agents to initiate infection, allowing immunological studies under defined host conditions. Finally, the model and each technique introduced here could potentially give rise to use of the methodologies to examine other infectious diseases of the lower female genital tract (bacterial, parasitic, viral) and respective local or systemic host defenses. PMID:22215135

Yano, Junko; Fidel, Paul L

2011-12-08

241

Vaginal epithelial surface appearances in women using vaginal rings for contraception  

Microsoft Academic Search

Vaginal inspections using colposcopy before insertion of contraceptive vaginal rings and at 2-month intervals during ring use were conducted on 169 users of four different formulations. The rings studied released Nestorone® alone (50, 75, 100 ?g daily over 6 months); ethinyl estradiol: Nestorone (30:100 and 15:150 ?g daily over 6 months); ethinylestradiol:norethindrone acetate (20:1000 and 15:1000 ?g daily over 4

Ian S Fraser; Maria Lacarra; Daniel R Mishell Jr; Francisco Alvarez; Vivian Brache; Pekka Lähteenmäki; Kaisa Elomaa; Edith Weisberg; Harold A Nash

2000-01-01

242

Liposomal gels for vaginal drug delivery.  

PubMed

The aim of our study was to develop a liposomal drug carrier system, able to provide sustained and controlled release of appropriate drug for local vaginal therapy. To optimise the preparation of liposomes with regards to size and entrapment efficiency, liposomes containing calcein were prepared by five different methods. Two optimal liposomal preparations (proliposomes and polyol dilution liposomes) were tested for their in vitro stability in media that simulate human vaginal conditions (buffer, pH 4.5). To be closer to in vivo application of liposomes and to achieve further improvement of their stability, liposomes were incorporated in vehicles suitable for vaginal self-administration. Gels of polyacrylate were chosen as vehicles for liposomal preparations. Due to their hydrophilic nature and bioadhesive properties, it was possible to achieve an adequate pH value corresponding to physiological conditions as well as desirable viscosity. In vitro release studies of liposomes incorporated in these gels (Carbopol 974P NF or Carbopol 980 NF) confirmed their applicability as a novel drug carrier system in vaginal delivery. Regardless of the gel used, even 24 h after the incubation of liposomal gel in the buffer pH 4.5 more than 80% of the originally entrapped substance was still retained. PMID:11337174

Paveli?, Z; Skalko-Basnet, N; Schubert, R

2001-05-21

243

Adhesion of Tritrichomonas foetus to Bovine Vaginal  

Microsoft Academic Search

An in vitro culture system of bovine vaginal epithelial cells (BVECs) was developed to study the cytopatho- genic effects of Tritrichomonas foetus and the role of lipophosphoglycan (LPG)-like cell surface glycoconjugates in adhesion of parasites to host cells. Exposure of BVEC monolayers to T. foetus resulted in extensive damage of monolayers. Host cell disruption was measured quantitatively by a trypan

Epithelial Cells; B. N. SINGH; J. J. LUCAS; D. H. BEACH; S. T. SHIN; R. O. GILBERT

1999-01-01

244

Anterior vaginal wall repair using local anaesthesia  

Microsoft Academic Search

Background: The purpose of the present study was to describe the possibility of surgical repair of anterior vaginal prolapse including amputation of the cervix using local anaesthesia. The description was made according to postoperative complication, recurrence rate, influence on urinary incontinence, and satisfaction of the patient. Material and methods: Eighty-three women were consecutively operated in the anterior wall of the

Susanne Maigaard Axelsen; Karl Møller Bek

2004-01-01

245

[Vaginal polyp in an infant girl].  

PubMed

A case of vaginal polyp in an infant girl was presented. The tumor was polypoid shape and yellow so that it resembled sarcoma botryoides. Histopathological findings showed hamartomatous appearance with hemangiomatous portions in the stroma. For 5 years after simple resection, she has been well without recurrence. PMID:3425530

Takahashi, G

1987-08-01

246

Vaginal Lacerations from Consensual Intercourse in Adolescents  

ERIC Educational Resources Information Center

|Objective: (1) To describe lacerations of the vaginal fornices, an injury known to be associated with consensual sexual intercourse, including known complications and treatment course, (2) to contrast these injuries with injuries sustained during sexual assault, and (3) to discuss the assessment of adolescent patients for sexual injuries.…

Frioux, Sarah M.; Blinman, Thane; Christian, Cindy W.

2011-01-01

247

Seton treatment for perianal Crohn's fistulas  

Microsoft Academic Search

In this study, we evaluated the efficacy of long-term seton drainage in the management of 13 patients with severe perianal Crohn's fistulas which had proven to be intractable to conventional therapy. After adequate curettage of the fistulous tracts and infected tissue, either a Penrose drain or a fine polyethylene catheter was inserted to encircle the tracts and tied. Patients were

Kazutaka Koganei; Akira Sugita; Hirofumi Harada; Tsuneo Fukushima; Hiroshi Shimada

1995-01-01

248

Clinical characteristics of dural arteriovenous fistula  

Microsoft Academic Search

Intracranial dural arteriovenous fistula (DAVF) is an uncommon neurosurgical condition; in particular, it has been infrequently reported in Korea. To understand the general clinical characteristics of DAVFs, the authors reviewed 53 cases and analyzed factors affecting DAVF hemorrhage of and treatment outcome. Since 1980 we have encountered 480 pial and 53 DAVFs, a ratio of 9.1 to 1. The age

Myoung Soo Kim; Dae Hee Han; O-Ki Kwon; Chang-Wan Oh; Moon Hee Han

2002-01-01

249

Thoracoscopic repair of tracheoesophageal fistula in newborns  

Microsoft Academic Search

Background: Advancements in minimally invasive surgery in neonates have allowed even the most complex neonatal procedures to be approached using these techniques. Methods: During a period of 15 months, 8 patients born with a proximal esophageal atresia and a distal tracheoesophageal fistula underwent repair thoracoscopically. Weights ranged from 2.1 to 3.4 kg and operating times ranged from 55 to 120

Steven S. Rothenberg

2002-01-01

250

Proximal forearm fistula for maintenance hemodialysis  

Microsoft Academic Search

Effective hemodialysis demands ready access to the peripheral circulation. For brief courses of treatment, the standard Quinton-Scribher Silastic Teflon Shunt [1] successfully fulfills this requirement. However, infection and thrombosis make such shunts unsuitable for use in maintenance hemodialysis. In 1966, Brescia, Cimino, and Hurlwith introduced a surgically–created fistula between the cephalic vein and the radial artery at the wrist [2].

Kenneth C Gracz; Todd S Ing; Lian-Sen Soung; Kent F W Armbruster; Sandra K Seim; Frederick K Merkel

1977-01-01

251

[Traumatic hepaticoportal fistula. Apropos of a case].  

PubMed

A case of post-traumatic hepaticoportal arteriovenous fistula between common hepatic artery and portal vein is reported. This localization of the lesion is exceptional, and early, marked clinical manifestations allow rapid diagnosis and treatment before the development of a portal hypertension. PMID:4044708

Calen, S; Janky, E; Nicolau, H; Durandeau, A; Videau, J

252

Colocutaneous Fistula Complicating Therapeutic Mesenteric Embolisation  

PubMed Central

Percutaneous embolotherapy has now assumed an important role in the management of massive colonic haemorrhage. However, this therapeutic option is associated with a significant risk of irreversible segmental colonic ischaemia. We present a case where distal segmental ischaemia led to a colocutaneous fistula, a complication not reported so far in the literature.

Camprodon, Ram; Jacob, S; George, ML; Karani, JB; Leather, AJM

2007-01-01

253

Endovascular management of spinal dural arteriovenous fistulas  

Microsoft Academic Search

Spinal dural arteriovenous fistulas (SDAVFs) represent the most frequent spinal arteriovenous malformation and have an ominous natural history if left untreated. In the present review, we describe the spinal vascular anatomy, pathophysiology and clinical manifestations of SDAVFs, and the current role of endovascular embolization in this type of lesion.

Athos Patsalides; Alejandro Santillan; Jared Knopman; Apostolos J Tsiouris; Howard A Riina; Y Pierre Gobin

2010-01-01

254

Radiation therapy for primary vaginal carcinoma  

PubMed Central

Brachytherapy plays a significant role in the management of cervical cancer, but the clinical significance of brachytherapy in the management of vaginal cancer remains to be defined. Thus, a single institutional experience in the treatment of primary invasive vaginal carcinoma was reviewed to define the role of brachytherapy. We retrospectively reviewed the charts of 36 patients with primary vaginal carcinoma who received definitive radiotherapy between 1992 and 2010. The treatment modalities included high-dose-rate intracavitary brachytherapy alone (HDR-ICBT; two patients), external beam radiation therapy alone (EBRT; 14 patients), a combination of EBRT and HDR-ICBT (10 patients), or high-dose-rate interstitial brachytherapy (HDR-ISBT; 10 patients). The median follow-up was 35.2 months. The 2-year local control rate (LCR), disease-free survival (DFS), and overall survival (OS) were 68.8%, 55.3% and 73.9%, respectively. The 2-year LCR for Stage I, II, III and IV was 100%, 87.5%, 51.5% and 0%, respectively (P = 0.007). In subgroup analysis consisting only of T2–T3 disease, the use of HDR-ISBT showed marginal significance for favorable 5-year LCR (88.9% vs 46.9%, P = 0.064). One patient each developed Grade 2 proctitis, Grade 2 cystitis, and a vaginal ulcer. We conclude that brachytherapy can play a central role in radiation therapy for primary vaginal cancer. Combining EBRT and HDR-ISBT for T2–T3 disease resulted in good local control.

Murakami, N.; Kasamatsu, T.; Sumi, M.; Yoshimura, R.; Takahashi, K.; Inaba, K.; Morota, M.; Mayahara, H.; Ito, Y.; Itami, J.

2013-01-01

255

Radiation therapy for primary vaginal carcinoma.  

PubMed

Brachytherapy plays a significant role in the management of cervical cancer, but the clinical significance of brachytherapy in the management of vaginal cancer remains to be defined. Thus, a single institutional experience in the treatment of primary invasive vaginal carcinoma was reviewed to define the role of brachytherapy. We retrospectively reviewed the charts of 36 patients with primary vaginal carcinoma who received definitive radiotherapy between 1992 and 2010. The treatment modalities included high-dose-rate intracavitary brachytherapy alone (HDR-ICBT; two patients), external beam radiation therapy alone (EBRT; 14 patients), a combination of EBRT and HDR-ICBT (10 patients), or high-dose-rate interstitial brachytherapy (HDR-ISBT; 10 patients). The median follow-up was 35.2 months. The 2-year local control rate (LCR), disease-free survival (DFS), and overall survival (OS) were 68.8%, 55.3% and 73.9%, respectively. The 2-year LCR for Stage I, II, III and IV was 100%, 87.5%, 51.5% and 0%, respectively (P = 0.007). In subgroup analysis consisting only of T2-T3 disease, the use of HDR-ISBT showed marginal significance for favorable 5-year LCR (88.9% vs 46.9%, P = 0.064). One patient each developed Grade 2 proctitis, Grade 2 cystitis, and a vaginal ulcer. We conclude that brachytherapy can play a central role in radiation therapy for primary vaginal cancer. Combining EBRT and HDR-ISBT for T2-T3 disease resulted in good local control. PMID:23559599

Murakami, N; Kasamatsu, T; Sumi, M; Yoshimura, R; Takahashi, K; Inaba, K; Morota, M; Mayahara, H; Ito, Y; Itami, J

2013-04-04

256

`Normal' vaginal microbiology of women of childbearing age in relation to the use of oral contraceptives and vaginal tampons  

PubMed Central

The vaginal microbiology of women attending a family planning clinic was found to be unrelated to the use of oral contraceptives and vaginal tampons. Beta haemolytic streptococci isolated from this `normal' population were compared with those from 1,104 women attending general practitioners complaining of vaginal discharge. There is a caution regarding the indications for antibiotic therapy. Observations were made on the effects of contamination of vaginal swabs with yeasts and ?-haemolytic streptococci from the vulva. The persistent character of the vaginal flora over a six-month period is described.

Morris, C. A.; Morris, Delia F.

1967-01-01

257

Benign vaginal polyp: a histological, histochemical and immunohistochemical study of 20 polyps with comparison to normal vaginal subepithelial layer.  

PubMed

Twenty benign vaginal polyps from 18 patients, together with sections from normal vaginal epithelium, were studied histologically, histochemically using elastic van Gieson stain and immunohistochemically using monoclonal antibodies against vimentin, desmin and actin. The striking finding was the similarity, both histologically and immunohistochemically, of the stroma of vaginal polyps to that of the loose subepithelial layer found in normal vagina. The important difference was the marked degeneration of the elastic tissue, increased number of stellate and giant fibroblasts and subepithelial condensation of fibroblasts in the polyps. These findings support the hypothesis that vaginal polyps may represent a reactive hyperplasia of the loose subepithelial zone of the vaginal wall. PMID:1302457

al-Nafussi, A I; Rebello, G; Hughes, D; Blessing, K

1992-02-01

258

Closure of proximal colorectal fistulas using fibrin sealant.  

PubMed

Fibrin glue has been used in upper gastrointestinal and perianal fistula disease, but its success in proximal colorectal pathology has not been widely documented. This report describes the use of endoscopically injected fibrin glue as a successful adjunct to traditional methods in accelerating the closure of colorectal fistulas. A retrospective review was performed on cases of colon and rectal fistulas treated with fibrin glue using an endoscopic technique of injection. Fistulas were injected via a flexible fiberoptic endoscope with fluoroscopic guidance (three) or directly with a rigid proctoscope (one). Fibrin glue was mixed directly from cryoprecipitate, thrombin, and calcium (one) or using a Tisseel kit (three) (Baxter, Deerfield, IL). Four patients were identified and included: two J-pouch fistulas, a colocutaneous fistula, and a complex rectocutaneous fistula. The median duration of fistula was 33 days (range 4-365 days). Total parenteral nutrition and bowel rest were used in two patients and three required drainage of an abscess. All fistulas were obliterated and patients required a mean of one application of fibrin glue (range one to two). The mean time to resuming a regular diet postinjection was 2 days (range 1-5). No complications were identified. Fistula resolution was documented in all cases with a contrast enema and no patient has had a fistula recurrence at a median follow-up of 12 months (range 6-65). This preliminary series demonstrates that fibrin glue can be used to obliterate proximal rectal, colonic, and pouch fistulas. Endoscopy and fluoroscopy may aid in administering the fibrin glue. This adjunctive technique may shorten the time to fistula closure and may allow some patients to avoid further surgery. PMID:12132744

Lamont, Jeffrey P; Hooker, Glen; Espenschied, Jonathan R; Lichliter, Warren E; Franko, Edward

2002-07-01

259

Effect on vaginal pH of a polycarbophil vaginal gel compared with an acidic douche in women with suspected bacterial vaginosis: a randomized, controlled study  

Microsoft Academic Search

Background: Vaginal pH is a key factor in maintaining a healthy vaginal ecosystem. An increase in vaginal pH is commonly observed during bacterial vaginosis.Objective: This study was undertaken to compare the effects of polycarbophil, a new bioadhesive polymer in gel form, with those of an acidic vaginal douche on restoration of physiologic vaginal pH in women with a vaginal pH

Massimo Milani; Bruno Molteni; Ilaria Silvani

2000-01-01

260

Endoscopic treatment of postoperative enterocutaneous fistulas after bariatric surgery with the use of a fistula plug: report of five cases.  

PubMed

Anastomotic leaks frequently occur after bariatric surgery and their management includes different options. The present study describes the management of enterocutaneous fistulas in patients in whom surgical or endoscopic treatments have failed, by insertion of a biomaterial (Surgisis fistula plug) to facilitate healing of the gastrocutaneous fistula. Five patients with leaks after bariatric surgery were treated. All patients had undergone previous failed surgical or endoscopic attempt(s) at closure. Our technique entailed insertion of the Surgisis fistula plug into the fistula tract by a "rendezvous" procedure, via both percutaneous and endoscopic routes. The data were collected retrospectively. Initially, two patients were treated by fistula plug alone and three received fistula plug plus a self-expanding stent. In two patients, cutaneous fistula outflow ceased within a few days. The other three patients required one additional endoscopic procedure. At the end we observed healed leaks in four of the five patients (80 %). The median follow-up duration was 18 months. In conclusion, the combined therapy consisting of fistula plug implantation with optional stenting helps closure in these difficult refractory cases of gastrocutaneous fistula. PMID:19533563

Toussaint, E; Eisendrath, P; Kwan, V; Dugardeyn, S; Devière, J; Le Moine, O

2009-06-16

261

Aortocoronary bypass graft fistula after surgical treatment of circumflex coronary artery fistula: a unique variation of a rare condition successfully treated with percutaneous embolization.  

PubMed

Multiple coronary artery fistulae are rare, complications can be life-threatening, and with large or symptomatic fistulae, intervention is mandatory. Both surgical and percutaneous interventions are well-described. We believe this is the first report of the embolization of an acquired fistula following initial surgical treatment of multiple congenital fistulae. PMID:19903688

White, Ralph W; Sivananthan, Mohan U; Kay, Philip H

2009-11-10

262

Tumor-bowel fistula: what radiologists should know.  

PubMed

Tumor-bowel fistula is an under reported complication of abdomino-pelvic malignancies which may occur spontaneously due to tumor growth or can be associated with cancer treatment. Chemotherapy and radiotherapy are commonly responsible for tumor-bowel fistulas. Molecular targeted therapies are a new class of drugs that can cause tumor fistulization due to their antiangiogenic properties. Clinically, the fistula can be asymptomatic or can result in devastating complications. Imaging helps in the prompt detection of these fistulas and the complications associated with them. Management of tumor-bowel fistula is individualized but often involves discontinuation of the associated treatment. Radiologists should promptly alert the oncology team about the presence of tumor-bowel fistula and any risk factors for its occurrence like pneumatosis or large metastatic deposits close to bowel loops. PMID:23455947

Tirumani, Sree Harsha; Baez, Juan C; Jagannathan, Jyothi P; Shinagare, Atul B; Ramaiya, Nikhil H

2013-10-01

263

Association between atopy and recurrent vaginal candidiasis  

PubMed Central

To determine whether there is an association between atopy and recurrent vaginal candidiasis (RVC) and to evaluate the type-2 immune response in patients with RVC. Evaluation of immediate hypersensitivity skin tests to aeroallergens, measurement of total IgE and Candida albicans specific IgE and levels of IL-5 in 44 women with RVC and 26 with sporadic vaginal candidiasis (SVC). Statistical analyses were performed by Mann–Whitney test and ?2 test with Yates correction. History of atopy (68%) and positive skin test (42%) were higher (P < 0·05) in RVC than in patients with SVC. No significant difference was found in total IgE, C. albicans specific IgE and IL-5 levels. There was a strong association between atopy and RVC, but type-2 immune response to C. albicans antigen was absent or similar in the two groups of patients.

Neves, NA; Carvalho, LP; De Oliveira, MAM; Giraldo, PC; Bacellar, O; Cruz, AA; Carvalho, EM

2005-01-01

264

Cytolytic vaginosis: misdiagnosed as candidal vaginitis.  

PubMed Central

OBJECTIVES: In this study, 210 women with vaginal discharge and other symptoms/signs of genital pathology suggestive of vulvovaginal candidiasis (VVC) were involved in order to distinguish true WC and cytolytic vaginosis (CV) cases. METHODS: Fungal cultures, 10% potassium hydroxide (KOH) and Gram stained preparations and pH measurements were performed on the vaginal discharge material of each patient. RESULTS: Fifteen patients (7.1%) were diagnosed with cytolytic vaginosis according to their clinical and microbiological findings, including abundant lactobacilli, fragmented epithelial cells and/or free nuclei due to cytolysis, seen in their discharge materials on microscopic examination, but no fungal growth. CONCLUSIONS: The results of this study may contribute to the reports in the literature indicating the importance of such disorders, which are generally misdiagnosed as candidiasis.

Cerikcioglu, Nilgun; Beksac, M Sinan

2004-01-01

265

Murine Models of Vaginal Trichomonad Infections  

PubMed Central

Trichomonas vaginalis and Tritrichomonas foetus cause common sexually transmitted infections in humans and cattle, respectively. Mouse models of trichomoniasis are important for pathogenic and therapeutic studies. Here, we compared murine genital infections with T. vaginalis and T. foetus. Persistent vaginal infection with T. foetus was established with 100 parasites but T. vaginalis infection required doses of 106, perhaps because of greater susceptibility to killing by mouse vaginal polymorphonuclear leukocytes. Infection with T. vaginalis persisted longest after combined treatment of mice with estrogen and dexamethasone, whereas infection was only short-lived when mice were given estrogen or dexamethasone alone, co-infected with Lactobacillus acidophilus, and/or pretreated with antibiotics. Infection rates were similar with metronidazole-resistant (MR) and metronidazole-sensitive (MS) T. vaginalis. High dose but not low dose metronidazole treatment controlled infection with MS better than MR T. vaginalis. These murine models will be valuable for investigating the pathogenesis and treatment of trichomoniasis.

Cobo, Eduardo R.; Eckmann, Lars; Corbeil, Lynette B.

2011-01-01

266

Probiotic and prebiotic applications for vaginal health.  

PubMed

Infections of the urogenital tract in women are extremely common, and there is no evidence of a reduction in incidence. Treatment and preventive strategies have been relatively unchanged for 50 years. The concept of using probiotic lactobacilli or prebiotics that stimulate the growth of protective organisms emerged in the mid-1980s and has led to several strains being tested successfully in women. With the advent of genomic profiling of the healthy vaginal microbiota, an improved understanding of metabolic systems within lactobacilli, and the ability to deliver products in food and supplement forms, the future should see new ways for women to restore and maintain their vaginal health, without the side effects of pharmaceutical agents. Indeed, studies indicate that probiotics can be taken in conjunction with the antibiotics and antifungal agents used to eradicate infections. In the future, probiotics and prebiotics will represent an important adjunct to pharmaceutical and other approaches used to care for feminine health. PMID:22468339

Reid, Gregor

267

Trial of vaginal breech delivery: current role.  

PubMed

Breech presentation occurs at term in approximately 3% to 4% of singleton gestations. This presentation is associated with a variety of maternal and fetal conditions including preterm labor, abnormal amniotic fluid volume, hydrocephaly, anencephaly, mullerian anomalies, abnormal placentation, and multifetal gestation. Cesarean delivery has been associated with increased risk of subsequent accreta, placenta previa, hemorrhage, and hysterectomy. The Term Breech Trial initially suggested that planned vaginal breech delivery is associated with increased neonatal morbidity and mortality compared with planned cesarean delivery. Long-term follow-up of these vaginally delivered infants contradict the initial findings. Current debate surrounds the dilemma of whether the untoward complications of cesarean delivery are warranted given uncertain minimal increases in neonatal survival and improvement in neurologic outcome with planned cesarean. PMID:17513938

Yamamura, Yasuko; Ramin, Kirk D; Ramin, Susan M

2007-06-01

268

[Vaginal metastasis of renal carcinoma (author's transl)].  

PubMed

Four cases of vaginal metastases of renal carcinoma are reported. This is an incidence of 1.3% in 313 operated patients (from 1/1/70 to 12/31/76). A surgical treatment of primary renal carcinoma and vaginal metastasis seems to be reasonable in there cases. Since in accordance with the literature metastatic involvement of vagina and vulva seems not to be a very rare finding, the diagnostic in renal carcinoma should imply a gynecologic examination. Although in carcinoma of the left kidney metastatic spreading into the external female genitalia most probably occurs by a retrograde venous pathway (left ovarian vein), the way of dissemination in carcinoma of the right side is unclear. PMID:924104

Carl, P; Marx, F J

1977-11-01

269

Can group B streptococci cause symptomatic vaginitis?  

PubMed Central

BACKGROUND: Maternal cervicovaginal colonization with Lancefield group B streptococci (GBS) is an important risk factor for neonatal morbidity and mortality. About 15% of women are carriers of GBS. Usually, they are asymptomatic. CASES: We describe two patients with symptomatic vaginitis for which no apparent cause was found. Both patients were heavily colonized with GBS. After antibiotic treatment, both became asymptomatic and culture negative, but after recolonization with GBS, symptoms resumed. This phenomenon was repeatedly observed. After emergence of resistance to antibiotics, local application of chlorhexidine appeared to be the only useful treatment. CONCLUSION: We hypothesize that GBS-vaginitis may be a possible disease entity. Although at present it is not clear why some patients become symptomatic, we speculate that the immunologic response is somehow selectively hampered in such patients.

Honig, E; Mouton, J W; van der Meijden, W I

1999-01-01

270

Adolescent Experiences with the Vaginal Ring  

PubMed Central

Purpose To understand racial/ethnic minority adolescent females’ experiences with the vaginal ring. Methods We conducted in-depth interviews with a clinic-based sample of 32 young women aged 15–24 years who had used the vaginal ring. Results Qualitative analysis using grounded theory revealed that adolescents undergo a multi-stage process when trying the ring and adopting ring use. These stages include hearing about the ring, initial reactions, first experiences with insertion and removal, and first sexual experiences. Adolescents subsequently enter an assessment and adjustment stage in which they decide whether to adopt or discontinue ring use. Ultimately they share their experiences with friends. Conclusions The model developed provides a context within which providers may advise adolescents as they begin use of the ring. Some specific recommendations are offered.

Epstein, Laura B.; Sokal-Gutierrez, Karen; Ivey, Susan L.; Raine, Tina; Auerswald, Colette

2011-01-01

271

Development and evaluation of acid-buffering bioadhesive vaginal tablet for mixed vaginal infections.  

PubMed

An acid-buffering bioadhesive vaginal tablet was developed for the treatment of genitourinary tract infections. From the bioadhesion experiment and release studies it was found that polycarbophil and sodium carboxymethylcellulose is a good combination for an acid-buffering bioadhesive vaginal tablet. Sodium monocitrate was used as a buffering agent to provide acidic pH (4.4), which is an attribute of a healthy vagina. The effervescent mixture (citric acid and sodium bicarbonate) along with a superdisintegrant (Ac-Di-sol) was used to enhance the swellability of the bioadhesive tablet. The drugs clotrimazole (antifungal) and metronidazole (antiprotozoal as well as an antibacterial) were used in the formulation along with Lactobacillus acidophilus spores to treat mixed vaginal infections. From the ex vivo retention study it was found that the bioadhesive polymers hold the tablet for more than 24 hours inside the vaginal tube. The hardness of the acid-buffering bioadhesive vaginal tablet was optimized, at 4 to 5 kg hardness the swelling was found to be good and the cumulative release profile of the developed tablet was matched with a marketed conventional tablet (Infa-V). The in vitro spreadability of the swelled tablet was comparable to the marketed gel. In the in vitro antimicrobial study it was found that the acid-buffering bioadhesive tablet produces better antimicrobial action than marketed intravaginal drug delivery systems (Infa-V, Candid-V and Canesten 1). PMID:18181530

Alam, Mohd Aftab; Ahmad, Farhan Jalees; Khan, Zeenat Iqbal; Khar, Roop Krishen; Ali, Mushir

2007-12-14

272

Congenital urethrocutaneous fistula: Case report with review of literature  

PubMed Central

We are presenting two cases of congenital urethrocutaneous fistula on ventral penile shaft. Congenital urethral fistula is an extremely rare, but easily manageable anomaly that may be confused with hypospadias. Awareness of the entity will avoid complications. This condition may be associated with other anomalies like congenital hernias and anorectal malformations. Treatment of this entity is individualized according to site of fistula, associated anomalies and condition of the distal urethra. All the principles of hypospadias surgery should be strictly followed.

Bhatnagar, Ankur; Upadhyaya, Vijai D.; Kumar, Basant

2012-01-01

273

Early Recognition of H-Type Tracheoesophageal Fistula  

PubMed Central

Tracheoesophageal fistula (TEF) without associated esophageal atresia (EA) is a rare congenital anomaly. Diagnosis in neonatal period is usually not made and most of the patients are treated as cases of pneumonia. A case of H-type of tracheoesophageal fistula, diagnosed within 24 hours of delivery based upon choking and cyanosis on first trial of feed, is being reported. Diagnosis was confirmed with contrast esophagram. Through cervical approach fistula was repaired and baby had uneventful post operative outcome.

Elhassan, Elbagir

2012-01-01

274

Primary aortoduodenal fistula supplied by type II endoleak.  

PubMed

Aortoenteric fistulas are a rare but potentially lethal condition. Here we present an unusual case of a fistula between the excluded portion of an infrarenal aneurysm repaired by stent-grafting and the duodenum. The fistula was supplied by a type II endoleak. The patient was successfully treated by extra-anatomic bypass grafting and removal of the aneurysm sac and the stent-graft. PMID:22944574

Lind, Benjamin B; Jacobs, Chad E

2012-10-01

275

Subarachnoid-pleural fistula: unusual complication of thoracotomy.  

PubMed

A case of subarachnoid-pleural fistula caused by a traction injury of the intercostal neurovascular bundle during thoracotomy is presented. Headaches, air within the ventricles of the brain, and clear drainage from the chest catheter should alert the surgeon to the presence of a subarachnoid-pleural fistula. If spontaneous closure of the fistula does not occur after a brief trial of chest catheter drainage, early operative intervention is advised. PMID:6246314

Frantz, P T; Battaglini, J W

1980-06-01

276

[Arteriovenous fistula following a gunshot wound. Qualitative and quantitative diagnosis].  

PubMed

A man aged 33 years developed an arterio-venous fistula following a gunshot wound from behind in the right calf. The quality of the fistula could be demonstrated employing digital subtraction angiographic technique while the quantity was demonstrated employing 99Tc macroaggregated albumin. The localization of the fistula is important in view of the surgical procedure and the haemodynamic amount is important to determine cardiac involvement. PMID:2800020

Beck, A M; Bülow, J B; Mortensen, D P

1989-09-18

277

Palliating severe arteriovenous fistulae using absorbable pulmonary artery bands.  

PubMed

We report the use of an absorbable pulmonary artery band to limit postoperative cyanosis due to severe pulmonary arteriovenous fistulae in a 5-year-old girl with post-Fontan palliation takedown to a two-ventricle repair. At 1-year postoperatively, her fistulae had nearly resolved with no distortion of her pulmonary artery anatomy. This case demonstrates a novel approach to limiting cyanosis while pulmonary arteriovenous fistulae resolved after redirection of hepatic blood flow to the affected lung. PMID:20338368

Schumacher, Kurt R; Rocchini, Albert; Ohye, Richard G

2010-04-01

278

Favorable effect of 6Mercaptopurine on fistulae of Crohn's disease  

Microsoft Academic Search

Fistulae are distressing chronic complications of Crohn's disease which have served as one of the most common indications for surgical resection. While steroids and sulfasalazine have not been successful in closing fistulae, in a previous double-blind study 6-mercaptopurine (6-MP) was more effective than placebo in accomplishing this goal (31% vs 6%). Thirty-four patients with Crohn's disease fistulae were treated with

Burton I. Korelitz

1985-01-01

279

Superior mesenteric arteriovenous fistula embolisation complicated by bowel ischaemia.  

PubMed

Superior mesenteric arteriovenous fistulas are rare, especially when iatrogenic in origin. Management of these fistulas can be surgical or endovascular. Endovascular embolisation is the preferred modality with a low rate of complications. Among the reported complications, bowel ischaemia is considered an unlikely occurrence. We report a case of a complex iatrogenic arterioportal fistula that was managed by endovascular embolisation and controlled through both its inflow and outflow, and was later complicated by bowel ischaemia. PMID:23682091

Hussein, Maher; Issa, Ghada; Muhsen, Shirin; Haydar, Ali

2013-05-15

280

Vaginal Intercourse Frequency and Heart Rate Variability  

Microsoft Academic Search

We examined the relationship between recalled and diary recorded frequency of penile-vaginal intercourse (FSI) and both resting heart rate variability (HRV; an index of cardiac autonomic control and parasympathetic tone associated with cardiovascular health outcomes) and resting diastolic blood pressure (DBP) in 120 healthy adults aged 19-38 (subjects scoring above the 87th percentile on the Lie scale of the Eysenck

STUART BRODY; RAGNAR PREUT

2003-01-01

281

Posterior vaginal prolapse and bowel function  

Microsoft Academic Search

Objective: This study’s objectives were to describe symptoms related to bowel dysfunction in women with uterovaginal prolapse and to compare these symptoms according to extent of posterior vaginal prolapse. Study Design: One hundred forty-three women completed a questionnaire assessment of bowel function and underwent standardized physical examination according to the International Continence Society’s system for grading uterovaginal prolapse. Results: The

Anne M. Weber; Mark D. Walters; Lester A. Ballard; Delbert L. Booher; Marion R. Piedmonte

1998-01-01

282

VARIATION AND PREDICTORS OF VAGINAL DOUCHING BEHAVIOR  

PubMed Central

Introduction Vaginal douching is a widespread practice among American women. Little research has been done examining variation in the practice or identifying risk factors. Methods We collected data on douching, as well as hypothesized predictors of vaginal douching, as part of a cohort study on preterm birth. African-American women residing in Baltimore City, Maryland, were enrolled if they received prenatal care or delivered at The Johns Hopkins Medical Institution. Interview data were collected on 872 women between March 2001 and July 2004, with a response rate of 68%. Logistic regression analysis was selected to identify factors associated with douching in the 6 months prior to pregnancy. Results Almost two thirds of women reported ever douching and more than two thirds of those women reported douching in the 6 months prior to pregnancy. Variation was seen in the practice of douching with regard to frequency as well as technique. After adjusting for several confounders, prenatal enrollment (odds ratio [OR], 1.80; 95% confidence interval [CI], 1.29, 2.53), more unmet needs for time for “nonessentials” (OR, 1.83; 95% CI, 1.27, 2.63), smoking in the year prior to the birth (OR, 1.78; 95% CI, 1.22, 2.60), and age > 19 years (OR, 2.60; 95% CI, 1.36, 4.97) were significant predictors of douching in the 6 months prior to pregnancy. Discussion We identified considerable heterogeneity in the practice of vaginal douching in a cohort of low income African-American women. Conclusions Future studies should incorporate measures of the predictors of douching and detailed exposure information to determine the independent contribution of vaginal douching to health outcomes.

Misra, Dawn P.; Trabert, Britton; Atherly-Trim, Shelly

2007-01-01

283

Vernix Caseosa Peritonitis After Vaginal Delivery  

PubMed Central

Introduction Vernix caseosa peritonitis (VCP) is a very unusual complication caused by inflammatory response to amniotic fluid spilled into the maternal peritoneal cavity. Twenty-seven cases have been reported, and all occurred after cesarean section. Case presentation We present a case of VCP following vaginal delivery; this may be the first case reported after vaginal delivery. Mrs. A, 28 years old, gravida 3, para 2, with one previous cesarean section, was admitted at 41 weeks gestation in active labor. Vacuum extraction was performed to deliver a healthy male baby, 4.410 kg, Apgar scores 7, 8. She developed fever, acute abdominal pain, and distension about 3 hours after delivery. A diagnosis of acute abdomen was made. Laparotomy was performed and it revealed neither uterine scar rupture nor other surgical emergencies, but 500 mL of turbid fluid and some cheesy material on the serosal surface of all viscera. Biopsies were taken. She had a course of antibiotics and her recovery was complete. Histology of the peritoneal fluid and tissue biopsy resulted in a diagnosis of VCP. Conclusion Clinical diagnosis of peritonitis due to vernix caseosa should be considered in patients presenting postpartum with an acute abdomen after vaginal delivery.

Sadath, Shameema A.; Abo Diba, Fathiya I.; Nayak, Surendra; Shamali, Iman Al; Diejomaoh, Michael F.

2013-01-01

284

Chromosome 18q-Syndrome and 1p terminal duplication in a patient with bilateral vesico-ureteral reflux: case report and literature revision  

PubMed Central

Background Vesico-ureteral reflux (VUR) is a dynamic event in which a retrograde flow of urine is present into the upper tracts. VUR may occur isolated or in association with other congenital abnormalities or as part of syndromic entities. We present a patient with a bilateral primary VUR, syndromic disease caused by a large deletion of 18q (18q21.3-qter) and terminal duplication of 1p (1p36.32-p36.33). Case report The patient was 8 years old female with a disease including moderate growth retardation, psychomotor retardation, facial dysmorphism, single umbilical artery, umbilical hernia, urachal remnant, bilateral congenital clubfeet and renal-urinary disease. Chromosomal analysis and Array-CGH revealed two heterozygous chromosomal rearrangements: 1p terminal duplication and de novo 18q terminal deletion. She referred to our clinic to evaluation of bilateral hydronephrosis and right renal cortex thinning. Voiding cystourethrography demonstrated bilateral grade IV VUR and dimercaptosuccinic acid renal scintigraphy confirmed right renal cortex thinning and showed a cortical uptake of 75% of the left kidney and 25% of the right kidney. The patient underwent ureterovesical reimplantation after failure of 3 endoscopic submeatal Deflux injections with VUR resolution. Conclusions This is the first report involving a patient with 18q-syndrome and contemporary presence of 1p chromosomal terminal duplication. The coexistence of two chromosomal rearrangements complicates the clinical picture and creates a chimeric disorder (marked by characteristics of both chromosomal anomalies). Kidney problems, primarily VUR is reported in 15% of patients affected by 18-q syndrome and no cases is reported in the literature regarding a correlation between VUR and 1p36 chromosomal duplication.

2013-01-01

285

Gastrocolic fistulae in benign peptic ulcer disease.  

PubMed Central

Occurence of gastroenteric fistulae in non-surgically treated peptic ulcer disease is rare as suggested by only 26 cases published in the literature so far. We had the opportunity to care for 3 patients with this problem in a period of one year. At our institution, a search of the medical records dating back to 1955 yielded one additional case. Most of our patients had a history of salicylate or corticosteroid intake. We present here the details of these cases and discuss the possible role of the location of the ulcer and ulcerogenic anti-inflammatory drug ingestion in the causation of gastroenteric fistula. We believe the incidence of this uncommon entity may rise significantly with the more common use of salicylates and corticosteroids. Images Fig. 1. Fig. 2. Fig. 3.

Kumar, G K; Razzaque, M A; Naidu, V G; Barbour, E M

1976-01-01

286

[Tracheoesophageal fistulae: the state of art].  

PubMed

The article summarizes the experience of treatment of 107 patients with tracheoesophageal fistula of nonneoplastic etiology. Etiology, diagnostic and treatment approaches were analyzed and compared, depending on the time period. The proportion of patients with combined pathology as tracheoesophageal fistula and cicatrical stenosis of the trachea has significantly increased recently. The main cause of fistulation was the jatrogenic tracheal injury during the mechanical lung ventilation. Basic diagnostic methods were endoscopy and computed tomography. The main objective of emergency remains isolation of the tracheobronchial tree from the gastrointestinal tract. Radical surgery can cure 97.8% of patients with minimal risk, including comorbidity. Conservative treatment and palliative surgery should be used only in case of the curative treatment failure or on the preparatory stage. PMID:23503389

Parshin, V D; Vishnevskaia, G A; Rusakov, M A; Gudobski?, L M; Parshin, V V; Chernova, E A

2013-01-01

287

Recurrent cervical carcinoma presenting as a primary aortoduodenal fistula.  

PubMed

Aortoduodenal fistula is a rare cause of gastrointestinal (GI) bleeding, and carries high morbidity and mortality even in modern practice. Cervical carcinoma is a major health threat among adult women, and its recurrence is not uncommon. We herein present a case of primary aortoduodenal fistula because of recurrent cervical carcinoma. Our case demonstrated that diagnosis of primary aortoenteric fistula requires a high index of suspicion and a combination of diagnostic modalities to establish the diagnosis. Prompt diagnosis and rapid treatment are critical in reducing mortality and morbidity. Although rare, metastatic carcinoma can lead to aortoenteric fistula. PMID:20800434

Huang, Jih-Hsin; Chen, Jer-Shen; Chu, Shu-Hsun; Chiu, Kuan-Ming

2010-08-30

288

Conservative management of rectocutaneous fistula following radical perineal prostatectomy.  

PubMed

Inadvertent rectal injury during radical perineal prostatectomy may sometimes lead to the development of a rectocutaneous fistula. This has traditionally been managed with diverting colostomy until closure of the fistula is assured. We report 3 cases of rectocutaneous fistula following radical perineal prostatectomy, which were managed in a more conservative fashion. This included appropriate wound care, antibiotics, bowel rest, parenteral hyperalimentation, and, in the presence of a concomitant urine leak in 1 case, optimal urinary diversion and bed rest. All fistulas healed without incident. PMID:8638376

Lassen, P M; Mokulis, J A; Kearse, W S; Caballero, R L; Quinones, D

1996-04-01

289

Endovascular treatment of cerebral dural and pial arteriovenous fistulas.  

PubMed

Dural arteriovenous fistulas (DAVFs) are arteriovenous shunts from a dural arterial supply to a dural venous channel, typically supplied by pachymeningeal arteries and located near a major venous sinus. Pial arteriovenous fistulas (PAVFs) are composed of one or more arterial feeders draining into a single vein in the absence of an intervening nidus. Fistulas manifesting features of high risk for rupture should be treated aggressively, the spectrum of treatment varies from endovascular, surgical resection, and stereotactic radiosurgery. This article describes the natural history, clinical presentation, and treatment of dural and pial fistulas, with emphasis on endovascular treatment. PMID:24156854

Jabbour, Pascal; Tjoumakaris, Stavropoula; Chalouhi, Nohra; Randazzo, Ciro; Gonzalez, Luis Fernando; Dumont, Aaron; Rosenwasser, Robert

2013-05-16

290

[Hermetic closure of liplike fistulas during laparoscopic gastrostomy and jejunostomy].  

PubMed

The author has elaborated the method of additional hermetical closing of labioid fistulas of the stomach and jejunum on the basis of creation of a fibrous ring in edges of an exterior fistular orifice. In case of impaired hermeticity this ring allows permanent bearing of a cannula and hermetic closure of the fistula again. Doubling of the methods of hermetical closure of fistulas provided an opportunity to facilitate the technic of their creation up to a simple bringing out of the visceral wall into the abdominal wall puncture. Thus, 26 fistulas were established in laparotomy, and 60 operations were performed without a wide exposure of the abdominal cavity, using laparoscopy. PMID:128191

Prudkov, I D

1975-08-01

291

Iliac arterial-enteric fistulas occurring after pelvic irradiation  

SciTech Connect

Fistulas from the iliac artery to the bowel constitute a condition that is often lethal. Excluding fistulas related to vascular grafts, a review of previously reported cases shows that they are most often due to atherosclerotic iliac aneurysms. Three unusual cases of this condition that occurred after high-dose pelvic irradiation for treatment of cancer are presented; in no case was recurrent tumor evident. These cases suggest that high-dose pelvic irradiation can predispose to the formation of iliac arterial-enteric fistulas, particularly if sepsis or inflammation develops. The definitive surgical management of these fistulas entails bowel resection, arterial ligation, and extra-anatomic bypass.

Vetto, J.T.; Culp, S.C.; Smythe, T.B.; Chang, A.E.; Sindelar, W.F.; Sugarbaker, P.H.; Heit, H.A.; Giordano, J.M.; Kozloff, L.

1987-05-01

292

Spontaneous aortocaval fistula: a case report and literature review.  

PubMed

Spontaneous aortocaval fistula is a rare complication of abdominal aortic aneurysms. We describe two cases of spontaneous aortocaval fistula. The first patient is a woman who was admitted with abdominal pain and pulsatile abdominal mass. Another patient was a man admitted with progressive abdominal pain and hypotension. Computed tomography (CT) scan in both patients showed an infrarenal aortic aneurysm and simultaneous contrast enhancement in the inferior vena cava. Both patients underwent an urgent laparotomy in which the diagnosis of an aortocaval fistula was confirmed. We review the literature on spontaneous aortocaval fistula as a consequenceof complicated aortic aneurysms. PMID:22737479

Ravari, H; Moini, M; Vahedian, M; Aliakbarian, M

2011-04-01

293

Aorto-cardiac fistulas in seven horses.  

PubMed

This report describes the history, clinical, electrocardiographic and echocardiographic findings, treatment, outcome and post-mortem findings in seven horses with aorto-cardiac fistula. Affected horses included 5 stallions, one gelding and one mare; 2 each of the Thoroughbred, Arabian and Standardbred breeds and one Thoroughbred-cross with a mean +/- s.d. age of 12 +/- 4 years, range 6-18 years. The presenting signs were acute distress (four horses), exercise intolerance (two horses) and the lesion was detected during a routine examination in one horse. Five horses had monomorphic ventricular tachycardia on admission and one other had a history of this arrhythmia. Five horses had a characteristic continuous murmur loudest in the right fourth intercostal space. Echocardiography (six horses) and/or post-mortem examination (four horses) revealed the horses had aorto-cardiac fistulas arising from the right aortic sinus in all five horses in which the site was recorded. Two horses had ruptured aneurysmal dilatations of the aortic wall at this site. Fistulas extended into the right ventricle in four horses; the right atrium in two horses, the left ventricle in one horse, and five horses had dissecting tracts in the septal myocardium. Horses survived for periods ranging from 24 h to 4 years. Aorto-cardiac fistula should be considered in the differential diagnosis for horses presenting with acute distress, bounding arterial pulse, a right-sided continuous murmur and/or monomorphic ventricular tachycardia, particularly in middle-aged or older stallions. Echocardiography is the technique of choice for confirming the diagnosis and demonstrating accompanying cardiac changes. PMID:9491514

Marr, C M; Reef, V B; Brazil, T J; Thomas, W P; Knottenbelt, D C; Kelly, D F; Baker, J R; Reimer, J M; Maxson, A D; Crowhurst, J S

294

Outcomes in esophageal atresia and tracheoesophageal fistula  

Microsoft Academic Search

Background\\/Purpose: The purpose of this analysis was to investigate outcomes in newborns with esophageal atresia (EA) or tracheoesophageal fistula (TEF) with respect to prognostic classifications and complications.Methods: Charts of all 144 infants with EA\\/TEF treated at British Columbia Children’s Hospital (BCCH) from 1984 to 2000 were reviewed. Patient demographics, frequency of associated anomalies, and details of management and outcomes were

David E Konkin; Wael A O’Hali; Eric M Webber; Geoffrey K Blair

2003-01-01

295

Endoscopic obliteration of recurrent tracheoesophageal fistula  

Microsoft Academic Search

Summary We report a successful endoscopic obliteration of a large recurrent tracheoesophageal fistula (diameter 0.6 cm, length 2.0 cm) in a 12-year-old girl, using a combination of Histoacryl (n-butyl-z-cyanoacrylate) and Aethoxysclerol injected through a polyethylene catheter. The severe pulmonary infection, which rendered surgery potentially life threatening, disappeared after the endoscopic closure. Since the obliteration, now over 12 months ago, the

Y. VANDENPLAS; R. Helven; H. Derop; A. Malfroot; T. De Backer; T. Beyens; A. Vandevelde; B. Desprechins; W. Laureys; G. Devis; P. Deconinck

1993-01-01

296

The vesicosigmoidal fistula: diagnosis and surgical treatment.  

PubMed

The authors report their experience in the diagnosis and treatment of 10 cases of vesicosigmoidal fistula. In accordance with the literature the most frequent presenting symptoms were of urinary origin. For the diagnosis urography was helpful, cystography and cystoscopy allowed the observation of a fistulous orifice, while barium enema confirmed, or removed probable doubts about the nature of the intestinal pathology. Surgical treatment varied from one-stage to multi-stage procedures. PMID:3667137

Malossini, G; Cavalleri, S; Comunale, L; Bianchi, G; Dagradi, V; Piccinelli, D; Lolli, P; Delaini, G C

1987-01-01

297

The vesicosigmoidal fistula: Diagnosis and surgical treatment  

Microsoft Academic Search

The authors report their experience in the diagnosis and treatment of 10 cases of vesicosigmoidal fistula. In accordance with\\u000a the literature the most frequent presenting symptoms were of urinary origin.\\u000a \\u000a For the diagnosis urography was helpful, cystography and cystoscopy allowed the observation of a fistulous orifice, while\\u000a barium enema confirmed, or removed probable doubts about the nature of the intestinal

G. Malossini; S. Cavalleri; L. Comunale; G. Bianchi; V. Dagradi; D. Piccinelli; P. Lolli; G. C. Delaini

1987-01-01

298

Vaginal route: a gynaecological route for much more than hysterectomy.  

PubMed

Vaginal hysterectomy is the method of choice for gynaecologists who carry out hysterectomies. Undertaking this procedure regularly will enhance the gynaecologist's level of skill and enable conditions such as ovarian cysts, broad ligament fibroids and other adnexal pathology to be dealt with vaginally during hysterectomy surgery without abdominal invasion. It is also important as the vaginal route allows access to the posterior cul-de-sac, which can facilitate surgery or offer an alternative route to achieving the desired outcome. In this chapter, we look at the main indications for vaginal surgery, and also at other conditions in which vaginal surgery may be suitable (e.g. benign and malignant conditions). We believe that gynaecologists who include vaginal surgery in their armamentarium are better equipped to serve their patients. PMID:21349773

Sheth, Shirish S; Paghdiwalla, Kurush P; Hajari, Anju R

2011-02-23

299

Spontaneous ventral urethral fistula in a young healty man and a modified surgical technique of urethral fistula repair  

PubMed Central

Urethral fistula is rare and is usually a complication of penile and urethral surgery. A few congenital cases have been reported. Also, one acquired spontaneous case in a diabetic man has been reported. We present the first case in the literature of a healthy man with a spontaneous ventral urethral fistula, with unknown etiology. We performed a modified technique of urethral fistula repair (four-layer technique).

Akkoc, Ali; Metin, Ahmet

2012-01-01

300

Surgical treatment of primary aortojejunal fistula?  

PubMed Central

INTRODUCTION Primary aortoenteric fistula is a rare clinical situation with a high mortality rate. One should suspect that condition when an abdominal aortic aneurysm is known to be present. We describe the case of a 60 year old man who presented with upper gastrointestinal bleeding as the first and sole manifestation of an abdominal aortic aneurysm, due to the rupture of the aneurysm in the jejunum. PRESENTATION OF CASE The patient was admitted with hematemesis and melena. He reported no abdominal pain. Upper gastrointestinal endoscopy disclosed no bleeding or lesions of the stomach and duodenum. Bleeding stopped the following day, only to recur 4 days later. The patient was then subjected to abdominal CT scan, which revealed the presence of a subrenal aortic aneurysm, with fistulization to the small intestine. At laparotomy the aortic aneurysm was adherent to the first centimeters of jejunum. The diseased aorta was excised and replaced with a Dacron Y graft in situ. DISCUSSION Primary aortojejunal fistulas are only rarely encountered. They usually are the result of a nonspecific aneurysm of the abdominal aorta. They usually manifest with premonitory bleeding, followed by catastrophic hemorrhage few days later. Even with surgery the mortality rate is high. CONCLUSION Diagnosis of primary aortoenteric fistula requires a high index of suspicion in cases of upper gastrointestinal bleeding, especially when endoscopy is negative and there is no knowledge of the existence of an abdominal aortic aneurysm. CT scan and prompt surgery are crucial to the survival of these patients.

Philippakis, George E.; Moustardas, Marios

2013-01-01

301

Relationship between lactobacilli and opportunistic bacterial pathogens associated with vaginitis  

PubMed Central

Background: Vaginitis, is an infectious inflammation of the vaginal mucosa, which sometimes involves the vulva. The balance of the vaginal flora is maintained by the Lactobacilli and its protective and probiotic role in treating and preventing vaginal infection by producing antagonizing compounds which are regarded as safe for humans. Aim: The aim of this study was to evaluate the protective role of Lactobacilli against common bacterial opportunistic pathogens in vaginitis and study the effects of some antibiotics on Lactobacilli isolates. Materials and Methods: In this study (110) vaginal swabs were obtained from women suffering from vaginitis who admitted to Babylon Hospital of Maternity and Paediatrics in Babylon province, Iraq. The study involved the role of intrauterine device among married women with vaginitis and also involved isolation of opportunistic bacterial isolates among pregnant and non pregnant women. This study also involved studying probiotic role of Lactobacilli by production of some defense factors like hydrogen peroxide, bacteriocin, and lactic acid. Results: Results revealed that a total of 130 bacterial isolates were obtained. Intrauterine device was a predisposing factor for vaginitis. The most common opportunistic bacterial isolates were Staphylococcus aureus, Escherichia coli, Streptococcus agalactiae, and Klebsiella pneumoniae. All Lactobacilli were hydrogen peroxide producers while some isolates were bacteriocin producers that inhibited some of opportunistic pathogens (S. aureus, E. coli). Lactobacilli were sensitive to erythromycin while 93.3% of them were resistant to ciprofloxacin and (40%, 53.3%) of them were resistant to amoxicillin and gentamycin respectively. Results revealed that there was an inverse relationship between Lactobacilli presence and organisms causing vaginitis. This may be attributed to the production of defense factors by Lactobacilli. Conclusion: The types of antibiotics used to treat vaginitis must be very selective in order not to kill the beneficial bacteria (Lactobacilli) that help in preservation of vaginal health and ecosystem as being one of the probiotic bacteria.

Razzak, Mohammad Sabri A.; Al-Charrakh, Alaa H.; AL-Greitty, Bara Hamid

2011-01-01

302

Vaginal Foreign Bodies and Child Sexual Abuse: An Important Consideration  

PubMed Central

Vaginal foreign bodies are a complaint occasionally encountered in pediatric clinics and emergency departments, and when pediatric patients present with a vaginal foreign body sexual abuse may not be considered. We describe two children with vaginal foreign bodies who were found to have been sexually abused. Each child had a discharge positive for a sexually transmitted infection despite no disclosure or allegation of abuse. We recommend that all pre-pubertal girls who present with a vaginal foreign body should be considered as possible victims of sexual abuse and should receive a sexual abuse history and testing for sexually transmitted infections.

Closson, Forrest T.; Lichenstein, Richard

2013-01-01

303

[Vaginal disbacteriosis--social and sexual risk factors].  

PubMed

The vaginal microbe equilibrium could be impaired by different agents. Many of the risk factors can change the preventive mechanisms of the vagina and can lead to inflammation and disease. We even do not suppose about the role of most of them in impairing of vaginal microbe equilibrium. The exact understanding of those risk factors and mechanisms by which they disturb the vaginal microbe balance could reduce female morbidity of vaginal disbacteriosis and vaginal inflammations. The aim of this literature synopsis is to review some of the most frequent risk factors for vaginal disbacteriosis and about how they change vaginal micro-flora with dominant lactobacillus within it. The most informative and detailed articles on the theme which were found in the resent literature as well as in Medline for the period between 1990 and 2012 were selected. The risk agents for vaginal disbacteriosis are: endogenetic, social, sexual, infectious and iatrogenic. The social and sexual factors are the most frequent in our daily round. The intensity and the kind of sexual life, smoking, homosexual connections, vaginal douching and contraception methods are included in them. All these factors depend on us. Thus we hope that through their popularization and discussion will help to prevent the females' health. PMID:23807976

Kovachev, S

2013-01-01

304

Laparoscopically assisted repair of vaginal evisceration after hysterectomy.  

PubMed

Vaginal evisceration is a rare condition most commonly associated with previous vaginal surgery. It usually presents with vaginal bleeding, lower abdominal pain and a protruding mass, and requires immediate assessment and surgical management to salvage the prolapsed bowel. Any delay in the treatment may result in bowel ischaemia and perforation which is associated with higher morbidity and mortality. We report a case of spontaneous vaginal evisceration during defaecation in a 56-year-old postmenopausal women 11 months post hysterectomy. This case highlights the benefits of a combined laparoscopic and transvaginal approach in the successful management of this surgical emergency. PMID:23667228

Nikolopoulos, Ioannis; Khan, Hasan; Janakan, Gnananandan; Kerwat, Rajab

2013-05-09

305

The Diagnosis of Spinal Dural Arteriovenous Fistulas.  

PubMed

Study Design. Retrospective consecutive case series.Objective. To review and analyze clinical presentations and radiological imaging of 326 consecutive spinal dural arteriovenous fistula (SDAVF) patients from two institutions.Summary of Background Data. The clinical presentations of SDAVF are nonspecific. Patients may be initially diagnosed with other spinal diseases. MRI can reveal spinal cord changes associated with the disorder, but neurosurgeons often overlook these changes.Methods. From 1989 to 2009, 326 patients were diagnosed with SDAVF and treated in the two institutions. We retrospectively reviewed the clinical records and radiological imaging of all patients, and collected and analyzed the related data.Results. 282 men and 44 women (men/women ratio 6.4:1, mean age 53.9 years, SD 12.1) were included in the study. Fistulas were located at the T7 spinal segment (41, 12.6%) but were more typically found at T5 to L5 (273, 82.5%). The most common initial symptoms were lower extremity weakness (234, 71.8%), sensory disturbance (229, 70.2%) and sphincter disturbance (87, 26.7%). These percentages increased, 85.6%, 80.8% and 52.5% respectively, until patients were properly diagnosed. The mean diagnostic time to SDAVF was 19.9 months (SD 25.2). Two major changes on MRI were intramedullary T2-weighted signal hyperintensity (284, 87.1%) and perimedullary dilated vessels (251, 77%). Fistulas were often located outside of the vertebral segments of T2-weighted signal change (P = 0.005). Magnetic Resonance Angiography (MRA) and Computed Tomography angiography (CTA) of 33 (71.7%) patients revealed perimedullary dilated vessels and precisely located fistulas in 19 (41.3%) patients. MRA and CTA studies of the perimedullary vessels also led to identification of a second fistula through angiography. Degenerative disc disease and myelitis were the most common misdiagnoses, and the patients were often treated incorrectly.Conclusion. "Worsening" and "Symptoms Combination" are progression characteristics of SDAVF. Patients should undergo spinal MRI when they are first suspected to have SDAVF. MRA and CTA as non-invasive angiography are helpful for diagnosis. PMID:23380827

Wang, Donghai; Yang, Ning; Zhang, Peng; Xu, Shuo; Li, Xueen; Zhao, Peng; Huang, Bin; Li, Xingang

2013-02-01

306

Interleukin1 Receptor Antagonist Gene Polymorphism, Vaginal Interleukin1 Receptor Antagonist Concentrations, and Vaginal Ureaplasma urealyticum Colonization in Pregnant Women  

Microsoft Academic Search

Ureaplasma urealyticum is the microorganism most frequently isolated from amniotic fluids of women in preterm labor. The relationship between vaginal colonization with U. urealyticum, vaginal interleukin-1 recep- tor antagonist (IL-1ra) levels, and the IL-1ra genotype in pregnant women was examined. Vaginal specimens, obtained with a cotton swab from 207 women in their first trimester of pregnancy, were tested for IL-1ra

Parrin T. Barton; Stefan Gerber; Daniel W. Skupski; Steven S. Witkin

2003-01-01

307

Imperforate anus with a rectovestibular fistula and pseudotail: a case report  

PubMed Central

Introduction Human tails and pseudotails are rare sacrococcygeal lesions that are associated with a wide variety of anomalies and syndromes. Anorectal malformations are also relatively uncommon congenital defects that often occur in conjunction with syndromes or other congenital abnormalities. The anomalies associated with both disorders determine the timing and approach to surgical correction. We present an unusual case of a patient with both imperforate anus and a pseudotail in the absence of a syndrome or other associated anomalies and we emphasize the necessity of a thorough preoperative evaluation. Case presentation A Caucasian girl was born at term after an uncomplicated pregnancy and was noted at birth to have a skin-covered posterior midline mass and imperforate anus with a fistula to the vaginal vestibule. Ultrasound and magnetic resonance imaging revealed a predominately fatty lesion without presacral extension and ruled out associated spinal and cord abnormalities. The patient underwent diversion with colostomy and a mucous fistula in the newborn period as a fistulogram demonstrated a long fistulous tract to normal rectum and it was anticipated that anoplasty and resection of the mass would require extensive posterior dissection. The sacrococcygeal mass was removed during posterior sagittal anorectoplasty at the age of six weeks which was determined to be a pseudotail because of the composition of brown fat and cartilage. The patient is now 14 months old with normal bowel function after a colostomy takedown. Conclusion A comprehensive preoperative assessment and thoughtful operative plan were necessary in this unusual case because of the extensive differential diagnosis for sacrococcygeal masses in the newborn and the frequency of anomalies and syndromes associated with tail variants and imperforate anus. The pediatricians and neonatologists who initially evaluate such patients and the surgeons who correct these disorders must be aware of the potential pitfalls in their management.

2010-01-01

308

Adenocarcinoma Arising from Vaginal Stump: Unusual Vaginal Carcinogenesis 7 Years After Hysterectomy due to Cervical Intraepithelial Neoplasia.  

PubMed

Primary vaginal adenocarcinomas are one of the rarest malignant neoplasms, which develop in the female genital tract. Because of the extremely low incidence, their clinical and pathologic characteristics are still obscure. Recently, we experienced a case of vaginal adenocarcinoma that appeared 7 yr after hysterectomy because of cervical intraepithelial neoplasia. The patient, a 65-yr-old obese woman, was diagnosed as having adenocarcinoma in the vaginal stump and was treated by simple tumor excision and radiation. Immunohistochemical and molecular biologic examinations indicated a potential association with human papilloma virus infection in the development of the vaginal adenocarcinoma. There has been no evidence of recurrence for 3 yr after the operation. PMID:24071878

Shibata, Takashi; Ikura, Yoshihiro; Iwai, Yasuhiro; Tokuda, Hisato; Cho, Yuka; Morimoto, Noriyuki; Nakago, Satoshi; Oishi, Tetsuya

2013-11-01

309

Tube loop (seton) drainage treatment of recurrent extrasphincteric perianal fistulae  

Microsoft Academic Search

Tube loop seton drainage treatment of multiply recurring high-spreading extrasphincteric perianal fistulae in 19 patients is reported in this study. The drainage loop setons make possible the rinsing of the wound following fistulectomy and also the bidirectional drainage of the wound discharge. Strangulation of the wound and an early closure of the fistula and hence the development of recurrence is

Gábor Balogh

1999-01-01

310

Treatment of transsphincteric anal fistulas by the seton technique  

Microsoft Academic Search

Twenty-one patients with high transsphincteric fistulas treated by the seton technique were re-examined after two to 14 years.\\u000a None had recurrent fistulas, but 13 (62 percent) had some degree of continence disturbances. All patients with anal deformities\\u000a had continence disorders.

Asbjørn Christensen; Lisbeth Nilas; John Christiansen

1986-01-01

311

Spinal Dural Arteriovenous Fistulas: MR and Myelographic Findings  

Microsoft Academic Search

PURPOSE: To examine the clinical and radiographic findings in a large group of patients having or suspected of having a spinal dural arteriovenous fistula. METHODS: An analysis of 240 spinal angiograms in 132 patients revealed 97 vascular malformations that included 66 spinal dural arteriovenous fistulas. Sixteen patients had 1 or more normal spinal angiograms that were per- formed for suspected

Julie R. Gilbertson; Gary M. Miller; Marc S. Goldman; W. Richard Marsh

312

Repair of oronasal fistulas with human amniotic membrane in minipigs.  

PubMed

We evaluated the use of multilayer human amniotic membrane (HAM) as a grafting material for the repair of mid-palate oronasal fistulas in seven Berlin minipigs. After two weeks, three animals had the fistulas repaired with multilayered HAM grafts, three had them repaired with a collagen-based dermal substitute (INTEGRA((R)), Integra Life Sciences, Plainsboro, NJ, USA), and one fistula was left untreated to serve as a control. Grafts were interposed between the oral and nasal mucosa, traversing the fistulas. After healing for 40 days, the pigs were killed for clinical, histological, and immunohistochemical examination. Two of the three fistulas closed with HAM were successful, the diameter of the third was reduced in size, and there was no change in the diameter of the fistula in the control. This study shows successful closure of oronasal fistulas in minipigs using interposed grafts of cryopreserved HAM, and offers promise as a simple and effective technique for tension-free closure of such fistulas. PMID:19477056

Kesting, Marco Rainer; Loeffelbein, Denys John; Classen, Mariella; Slotta-Huspenina, Julia; Hasler, Rafael Johannes; Jacobsen, Frank; Kreutzer, Kilian; Al-Benna, Sammy; Wolff, Klaus-Dietrich; Steinstraesser, Lars

2009-05-23

313

Double congenital fistulae with aneurysm diagnosed by combining imaging modalities.  

PubMed

Congenital coronary pulmonary artery fistula (CAF) is rare, and systemic-to-pulmonary artery fistula (SPAF) is even more so. Furthermore, congenital coronary pulmonary fistula associated with congenital SPAF is extremely rare. As far as we know, CAF and SPAF connected with an aneurysm have not been described very often. We described an 83-year-old woman with an aneurysm originating from a CAF connected to an aortopulmonary artery fistula. Chest radiography revealed a shadow at the left edge of the heart line. Multi-detector-row computed tomography (MDCT) with contrast enhancement and coronary cine angiography revealed that the shadow was an aneurysm connected to a tortuous fistula at the left anterior descending coronary artery. The aneurysm was formed by congenital coronary pulmonary and aortopulmonary artery fistulae. Echocardiography revealed predominantly systolic blood flow in the fistula from the left anterior descending coronary artery (LAD). Although neither MDCT, echocardiography nor coronary angiography alone could provide a comprehensive image of the anomaly, including the hemodynamics in the fistulae and their relationship with surrounding organs and tissues, their combination could provided important facts the led to a deeper understanding of this very uncommon occurrence. PMID:24145730

Tachibana, Motomi; Mukouhara, Naoki; Hirami, Ryouichi; Fujio, Hideki; Yumoto, Akihisa; Watanuki, Yutaka; Hayashi, Aiko; Suminoe, Isao; Koudani, Hiroshi

2013-10-01

314

Effects of recombinant human growth hormone on enterocutaneous fistula patients  

Microsoft Academic Search

AIM: To explore the effects of recombinant human growth hormone (rhGH) on intestinal mucosal epithelial cell proliferation and nutritional status in patients with enterocutaneous fistula. METHODS: Eight patients with enterocutaneous fistulas received recombinant human growth hormone (10 µg\\/d) for 7 d. Image analysis and immunohisto- chemical techniques were used to analyse the expression of proliferating cell nuclear antigen (PCNA) in

Guo-Sheng Gu; Jian-An Ren; Ning Li; Jie-Shou Li

2008-01-01

315

Salvage of immature forearm fistulas for haemodialysis by interventional radiology  

Microsoft Academic Search

Background. The goal of this article is to assess the value of endovascular techniques for the salvage of fistulas that fail to mature. Methods. Over a 6-year period, 52 dysfunctional and 17 thrombosed immature forearm fistulas (mean age 10 weeks) were treated by interventional radiology. Angiography was performed by puncture of the brachial artery but dilation of underlying stenoses was

Luc Turmel-Rodrigues; Albert Mouton; B eatrice Birmele ´; Luc Billaux; Naji Ammar; Olivier Grezard; Serge Hauss; Josette Pengloan

316

CT-Demonstrated Transcalvarial Channels Diagnostic of Dural Arteriovenous Fistula  

Microsoft Academic Search

Summary: MR imaging-evident intraosseous channels as- sociated with the presence of a dural arteriovenous fistula have been described in the literature. We describe these channels in relation to a case of dural arteriovenous fistula seen on CT. The presence of this subtle sign should be sought, and the area reviewed in all CT evaluations of patients with pulsatile tinnitus. Dural

Steven Alatakis; George Koulouris; Stephen Stuckey

317

Genetics Home Reference: Esophageal atresia/tracheoesophageal fistula  

MedlinePLUS

... literature OMIM Genetic disorder catalog Conditions > Esophageal atresia/tracheoesophageal fistula (often shortened to EA/TEF ) On this page: ... August 2012 What is EA/TEF? Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a condition resulting from abnormal ...

318

Esophageal Atresia and Tracheoesophageal Fistula: Surgical Experience Over Two Decades  

Microsoft Academic Search

Background. Despite improvements in survival, for infants born with esophageal atresia tracheoesophageal fistula, or both, the morbidity associated with repair of these anomalies remains high.Methods. This report retrospectively analyzes 81 patients with esophageal atresia, tracheoesophageal fistula, or both presenting to our institution between 1975 and 1995, with a focus on anastomotic complications.Results. There were 46 male and 35 female patients

Josephine Y Tsai; Leah Berkery; David E Wesson; S. Frank Redo; Nitsana A Spigland

1997-01-01

319

Postparotidectomy fistula: a different treatment for an old problem  

Microsoft Academic Search

There is little consensus on the optimal management of postparotidectomy salivary fistulas. Timely treatment is important since fistulas may result in wound dehiscence and infection. Management options include pressure dressings, total parotidectomy, tympanic neurectomy, graft interpositioning, surgical closure of the tract, radiation therapy, and pharmacotherapy. Unfortunately, many therapies require weeks to months for resolution and possess additional risks. The affected

Kevin Cavanaugh; Albert Park

1999-01-01

320

Diagnosis of pyriform sinus fistula in children via ultrasonography.  

PubMed

A pyriform sinus fistula is a rare congenital abnormality of the third or fourth branchial pouch that usually affects children. We report one case of the condition; ultrasound (US) imaged a heterogeneous mass with a hypoechoic area and air bubbles representing an abscess. Although these manifestations are rare, prominent and characteristic findings on US may facilitate the diagnosis of pyriform sinus fistula. PMID:23790565

Liu, Zhan; Tang, Shao-Shan

2013-06-19

321

Sigmoid colon fistula complicating ovarian cystadenocarcinoma: A rare finding  

Microsoft Academic Search

A case of sigmoid colon fistula complicating ovarian cystadenocarcinoma is reported. The entity demonstrated a large air-filled, thin-walled cystic lesion during barium enema examination. The differential diagnosis of distended air-filled cystic lesions is discussed and expanded to include colonic fistula complicating ovarian neoplasms.

Hiroshi Honda; Charles H. Lu; Thomas J. Barloon; Kimio Hashimoto

1990-01-01

322

Limits of Normal for Pressure Sensitivity in the Fistula Test  

Microsoft Academic Search

In patients with perilymphatic fistula (PLF), nystagmus may sometimes be elicited by application of pressure to the external ear canal. The extent to which the normal population also exhibits such ‘pressure sensitivity’ is presently unknown. Our goal was to determine the limits of normal pressure sensitivity and to quantify the performance of the fistula test. Our subjects consisted of 13

Timothy C. Hain; Vincent B. Ostrowski

1997-01-01

323

Iatrogenic arteriovenous fistula in the hand: a case report.  

PubMed

Peripheral intravenous cannulation is widely used in medicine. Arteriovenous fistulas are rare complications but their occurrence has never been reported in the hands. We report on a young patient who developed a high flow arteriovenous fistula on the dorsum of her hand two weeks after a failed peripheral intravenous cannulation attempt. PMID:22989555

Shararah, Abdul-Wahab H; Aldekhayel, Salah; Williams, H Bruce

2012-09-16

324

Ileocolic Arteriovenous Fistula with Superior Mesenteric Vein Aneurism: Endovascular Treatment  

Microsoft Academic Search

We report a case of a venous aneurysm secondary to an acquired ileocolic arteriovenous fistula in a 64-year-old woman with recurrent abdominal pain and history of appendectomy. The aneurysm was diagnosed by ultrasound and computed tomography. Angiography showed an arteriovenous fistula between ileocolic branches of the superior mesenteric artery and vein. This vascular abnormality was successfully treated with coil embolization.

Miguel Angel De Gregorio; Maria José Gimeno; Joaquin Medrano; Caudio Schönholz; Juan Rodriguez; Horacio D’Agostino

2004-01-01

325

Spontaneous closure of selected iatrogenic pseudoaneurysms and arteriovenous fistulae  

Microsoft Academic Search

Purpose: We report our approach to the management of postcatheterization femoral artery pseudoaneurysms and arteriovenous fistulae in an attempt to determine the frequency of spontaneous resolution of selected lesions.Methods: We studied 196 pseudoaneurysms, 81 arteriovenous fistulae, and 9 combined lesions that were identified by duplex scan. Indications for immediate surgical repair included pseudoaneurysm greater than 3 cm, enlarging hematoma, pain,

Boulos Toursarkissian; Brent T. Allen; Drazen Petrinec; Robert W. Thompson; Brian G. Rubin; Jeffrey M. Reilly; Charles B. Anderson; M. Wayne Flye; Gregorio A. Sicard

1997-01-01

326

Practical Guide to Diagnosing and Treating Vaginitis.  

PubMed

Bacterial vaginosis (BV), candidiasis, and trichomoniasis account for more than 90% of vaginal infections. BV typically is associated with a decrease in commensal, protective lactobacilli and a proliferation of other flora. Mobiluncus is pathognomonic but found in only 20% of cases. Presence of 3 of 4 criteria indicates BV: a homogenous noninflammatory discharge (not many WBCs); pH >4.5; clue cells (bacteria attached to borders of epithelial cells, > 20 % of epithelial cells); and a positive whiff test. New intravaginal BV preparations cause less-adverse systemic effects than oral regimens. Trichomonas vaginalis, a protozoan, appears to be sexually transmitted and causes up to 25% of vaginitis cases. Diagnosis is made by observation of a foul, frothy discharge; pH >4.5 (present in 70% of cases); punctate cervical microhemorrhages (25% of cases); and motile trichomonads on wet mount (50%-75% of cases). Recommended treatment is a single 2g dose of oral metronidazole. Treatment failure is usually due to nontreatment of the male partner. Candidiasis typically presents as a thick, "curdled" white discharge or vulvar pruritus, with a hyperemic vagina and an erythematous and/or excoriated vulva. Vaginal pH is usually in the normal range of 3.8-4.2 in uncomplicated candidiasis. Microscopic examination of the discharge reveals hyphae or budding yeast in 50%-70% of cases. While the most common offender is Candida albicans, Candida tropicalis and Candida glabrata have become increasingly prevalent. Approximately 15% of C albicans organisms are resistant to clotrimazole and miconazole. Recurrent infections may be treated with fluconazole 150mg weekly for up to 12 consecutive weeks. PMID:9746676

Plourd

1997-02-01

327

Optimisation techniques in vaginal cuff brachytherapy.  

PubMed

The aim of this study was to explore whether an in-house dosimetry protocol and optimisation method are able to produce a homogeneous dose distribution in the target volume, and how often optimisation is required in vaginal cuff brachytherapy. Treatment planning was carried out for 109 fractions in 33 patients who underwent high dose rate iridium-192 (Ir(192)) brachytherapy using Fletcher ovoids. Dose prescription and normalisation were performed to catheter-oriented lateral dose points (dps) within a range of 90-110% of the prescribed dose. The in-house vaginal apex point (Vk), alternative vaginal apex point (Vk'), International Commission on Radiation Units and Measurements (ICRU) rectal point (Rg) and bladder point (Bl) doses were calculated. Time-position optimisations were made considering dps, Vk and Rg doses. Keeping the Vk dose higher than 95% and the Rg dose less than 85% of the prescribed dose was intended. Target dose homogeneity, optimisation frequency and the relationship between prescribed dose, Vk, Vk', Rg and ovoid diameter were investigated. The mean target dose was 99+/-7.4% of the prescription dose. Optimisation was required in 92 out of 109 (83%) fractions. Ovoid diameter had a significant effect on Rg (p = 0.002), Vk (p = 0.018), Vk' (p = 0.034), minimum dps (p = 0.021) and maximum dps (p<0.001). Rg, Vk and Vk' doses with 2.5 cm diameter ovoids were significantly higher than with 2 cm and 1.5 cm ovoids. Catheter-oriented dose point normalisation provided a homogeneous dose distribution with a 99+/-7.4% mean dose within the target volume, requiring time-position optimisation. PMID:19470571

Tuncel, N; Garipagaoglu, M; Kizildag, A U; Andic, F; Toy, A

2009-05-26

328

Update in management of vaginal mesh erosion.  

PubMed

Mesh erosion is one of the major complications of prolapse surgery conducted by transvaginal approach. Following the extensive use of meshes and warning about potential complications, a new classification of mesh-related adverse events has been proposed. Due to the wide scope of clinical features, no standardized approach has been proposed. Surgery is required after failure of conservative management, mostly based on mesh partial or total excision by transvaginal route, following the classic rules of re-do vaginal surgery. Complex cases are best managed in tertiary reference centers. PMID:23873511

Cornu, Jean-Nicolas; Peyrat, Laurence; Haab, François

2013-10-01

329

[Vaginal infection caused by Saccharomyces cerevisiae].  

PubMed

In a woman of 26, who suffered from a vulvovaginal infection and had previously been treated for Candida vaginitis, Saccharomyces cerevisiae was cultured and identified. At her work she sold baking yeast. Topical treatment with amphotericin B 100 mg suppositories was successful. Microscopic examination (1000 x) of the discharge in saline showed haloed yeast cells. For treatment, oral ketoconazole or topical administration of amphotericin B or clotrimazole, in relatively high doses, may be applied. This yeast might be the cause of 'chronic candidiasis' more often than suspected, notably in women working in a bakery or a brewery. PMID:7783803

van Doorn, H C; Coelingh Bennink, F

1995-05-27

330

Vaginal contraceptive film gains wider acceptance.  

PubMed

In US health departments and family planning clinics, women are beginning to accept vaginal contraceptive film more widely. Further, direct sales of this method, which is also distributed over the counter, has increased. In fact, in 1991, vaginal contraceptive film was the top selling contraceptive in pharmacies. This 2.5 sq. inch water-soluble film is impregnated with nonoxynol-9. The woman uses her finger to insert the folded square as close as possible to the cervix 5-60 minutes before intercourse. If the time between acts of intercourse is greater than 1 hour, she must insert another square. After it dissolves, it is a firm gel removed by vaginal and cervical fluids. The company realizes that its relatively high cost (about $3.59 for 3 films) prevents some family planning providers from offering the film. It has tried to cut costs by not using extra packaging material and by manufacturing it in the US instead of ain England. A manager of the family planning clinic at R.E. Thomason County Hospital in El Paso, Texas, notes that user compliance is higher with the vaginal contraceptive film than foam. In fact, patients at the Planned Parenthood League of Middlesex County, New Jersey, favor the film because it is less messy than foam. Teenagers in El Paso prefer the film because of the privacy issue and gives them more control to protect themselves from pregnancy. A worker at the New Jersey clinic recommends the film as a backup method for women beginning to use oral contraceptives. She also suggests to patients requesting condoms to also use the film. The company makes the same recommendation. Yet, family planning workers note that some women cannot convince partners to use the condom. 90% of patients at the El Paso clinic are Hispanic, and they tend to not accept condom use. Some providers suggest using 2 applications of the film to defend against sexually transmitted diseases, but there is no evidence that double application actually does so. PMID:12317927

1992-09-01

331

New immunotherapeutic strategies to control vaginal candidiasis.  

PubMed

The widespread occurrence of mucosal infections caused by Candida, in particular recurrent vulvovaginal candidiasis among fertile-age women, together with the paucity of safe candidacidal antimycotics, have prompted a great number of investigations into the immunotherapy of candidal vaginitis. This article will discuss three different experimental approaches demonstrated to be potentially transferable to human disease: (1) the use of antibodies against well-defined cell-surface adhesins or enzymes; (2) the generation of yeast killer-toxin-like candidacidal anti-idiotypic antibodies and their engineered molecular derivatives (e.g. single chains, peptides); and (3) the generation of therapeutic vaccines and immunomodulators. PMID:11879772

Magliani, Walter; Conti, Stefania; Cassone, Antonio; De Bernardis, Flavia; Polonelli, Luciano

2002-03-01

332

Spontaneous cholecystocutaneous fistula as a rare complication of gallstones.  

PubMed

Spontaneous perforation of gallbladder as a complication of biliary stones may lead to a cholecystocutaneous abscess or fistula. The pathophysiology of this condition has been associated with increased pressure in the gallbladder, secondary to biliary obstruction. Ultrasonography and Computed Tomography (CT) can be used for diagnosis of cholecystocutaneous abscess or fistula. The treatment of fistula requires adequate drainage, antibiotics, followed by elective cholecystectomy with excision of the fistula. We report a case of spontaneous cholecystocutaneous fistula in an 89-year-old female patient who presented with obstructive jaundice and subcutaneous abscess in the right subcostal area. Abdominal CT scan showed gallstones and communication between the abscess and the gallbladder. First abdominal wall abscess was drained externally then cholecystectomy and exploration of common bile duct was performed (Fig. 3, Ref. 8). PMID:22794521

Ozdemir, Y; Yucel, E; Sucullu, I; Filiz, I; Gulec, B; Akin, M L; Yildiz, M

2012-01-01

333

MRI of perianal fistulas: bridging the radiological-surgical divide.  

PubMed

Perianal fistula is a clinical entity with multiple surgical treatment options. Recently, magnetic resonance imaging (MRI) has emerged as an important imaging modality in the management of perianal fistulas. It provides accurate description of the fistula within the anal canal in relation to the sphincter complex and other pelvic floor structures as well as the associated complications such as abscess. By understanding the surgical viewpoint, the appearance of perianal fistulas, associated complications, and post-treatment findings of commonly used surgical interventions can more accurately be interpreted to aid clinicians. The objective of the article is to review MRI indications and findings, radiological versus surgical classification schemes, and surgical treatment options for perianal fistulas. PMID:23242265

Gage, Kenneth L; Deshmukh, Swati; Macura, Katarzyna J; Kamel, Ihab R; Zaheer, Atif

2013-10-01

334

Nonclosure of rectourethral fistula during posterior sagittal anorectoplasty: Our experience  

PubMed Central

Aim: To study the effect of nonclosure of rectourethral (RU) fistula and to do a comparative analysis of the complications with and without nonclosure of RU fistula during posterior sagittal anorectoplasty (PSARP) in anorectal malformation cases (ARM). Materials and Methods: A total of 68 cases of ARM were included in the study group, of which 34 cases were those in whom RU fistula was not closed (group A) during PSARP. Another 34 successive cases were included in study group B in whom the RU fistula was closed as is conventionally done by using interrupted sutures. Results: Comparatively, group A had none or minimum urological complications as compared to Group B. Conclusion: RU fistula closure is not mandatory during PSARP and nonclosure avoids urological complications. It especially avoids urethral complications, which are 100% preventable.

Jadhav, Sudhakar; Raut, Amit; Mandke, Jui; Patil, Santosh; Vora, Ravindra; Kittur, Dinesh

2013-01-01

335

Iatrogenic esophago-tracheal fistula: Challenges in diagnosis and management  

PubMed Central

Esophageo-tracheal fistula is a rare condition, and in most cases such fistulas are caused by malignant disease or emergency endotracheal intubation. A case where a wrapped tablet produced a fistula between the esophagus and trachea is described. The patient is a male born in 1938 who swallowed a tablet without unwrapping it. The patient was treated with self-expanding metal stents (SEMS), but closure of the fistula was not achieved. Different examinations and treatment options are discussed. Surgical treatment for this condition has demonstrated considerable mortality and morbidity. In some cases closure of the fistula can be achieved by use of SEMS. Although we advise treatment of such cases with SEMS, in some cases treatment with stents will prove troublesome and the risk/benefit analysis will have to be reevaluated.

Hovde, ?istein; Lie, ?yvind Haugen; Johansson, Per Arthur; Stubhaug, ?ystein; Johnson, Egil; Hofstad, Bj?rn; Hauge, Truls

2013-01-01

336

Robotic-Assisted Laparoscopic Repair of a Vesicouterine Fistula  

PubMed Central

Background: As cesarean sections become a more common mode of delivery, they have become the most likely cause of vesicouterine fistula formation. The associated pathology with repeat cesarean deliveries may make repair of these fistulas difficult. Computer-enhanced telesurgery, also known as robotic-assisted surgery, offers a 3-dimensional view of the operative field and allows for intricate movements necessary for complex suturing and dissection. These qualities are advantageous in vesicouterine fistula repair. Case: A healthy 34-year-old woman who underwent 4 cesarean deliveries presented with a persistent vesicouterine fistula. Conservative management with bladder decompression and amenorrhea-inducing agents failed. Results: Robotic-assisted laparoscopic repair was successfully performed with the patient maintaining continence after surgery. Conclusion: Robotic-assisted laparoscopic repair of vesicouterine fistulas offers a minimally invasive approach to treatment of a complex disease process.

Chang-Jackson, Shao-Chun R.; Acholonu, Uchenna C.

2011-01-01

337

The association of carotid cavernous fistula with Graves' ophthalmopathy  

PubMed Central

Graves’ ophthalmopathy (GO) is one of the frequent manifestations of the disorder which is an inflammatory process due to fibroblast infiltration, fibroblast proliferation and accumulation of glycosaminoglycans. Eye irritation, dryness, excessive tearing, visual blurring, diplopia, pain, visual loss, retroorbital discomfort are the symptoms and they can mimic carotid cavernous fistulas. Carotid cavernous fistulas are abnormal communications between the carotid arterial system and the cavernous sinus. The clinical manifestations of GO can mimic the signs of carotid cavernous fistulas. Carotid cavernous fistulas should be considered in the differential diagnosis of the GO patients especially who are not responding to the standard treatment and when there is a unilateral or asymmetric eye involvement. Here we report the second case report with concurrent occurrence of GO and carotid cavernous fistula in the literature.

Celik, Ozlem; Buyuktas, Deram; Islak, Civan; Sarici, A Murat; Gundogdu, A Sadi

2013-01-01

338

Update on anal fistulae: Surgical perspectives for the gastroenterologist  

PubMed Central

Anal fistulae are common and debilitating; they are characterized by severe pain and discharge. They arise following infection near the anal canal, or as a primary event from an abscess in the abdomen, fistulating into the vagina or perianal skin. The term ‘cryptoglandular’ is given to abscesses arising from the anal glands. For many years, the treatment of choice was to lay open the fistula; however, this risks causing incontinence with potentially devastating consequences. Alternative surgical treatments include setons, fibrin glue, collagen plugs and flaps to cover the internal fistula opening. These have achieved varying degrees of success, as will be discussed. The present review also discusses anal fistulae in light of much recently published literature. Currently, anal fistulae remain challenging and require specialist expertise; however, new treatment options are on the horizon.

Tabry, Helena; Farrands, Paul A

2011-01-01

339

Fistulotomy or seton in anal fistula: a decisional algorithm.  

PubMed

Fistula in ano is a common proctological disease. Several authors stated that internal and external anal sphincters preservation is in the interest of continence maintenance. The aim of the present study is to report our experience using a decisional algorithm on sphincter saving procedures that achieved us to obtain good results with low rate of complications. From 2008 to 2011, 206 patients underwent surgical treatment for anal fistula; 28 patients underwent perianal abscess drainage plus seton placement of trans-sphincteric or supra-sphincteric fistula (13.6 %), 41 patients underwent fistulotomy for submucosal or low inter-sphincteric or low trans-sphincteric anal fistula (19.9 %) and 137 patients underwent partial fistulectomy or partial fistulotomy (from cutaneous plan to external sphincter muscle plan) and cutting seton placement without internal sphincterotomy for trans-sphincteric anal fistula (66.50 %). Healing rates have been of 100 % and healing times ranged from 1 to 6 months in 97 % of patients treated by setons. Transient fecal soiling was reported by 19 patients affected by trans-sphincteric fistula (11.5 %) for 4-6 months and then disappeared or evolved in a milder form of flatus occasional incontinence. No major incontinence has been reported also after fistulotomy. Fistula recurred in five cases of trans-sphincteric fistula treated by seton placement (one with abscess) (1/28) (3.5 %) and four with trans-sphincteric fistula (4/137) (3 %). Our algorithm permitted us to reduce to 20 % sphincter cutting procedures without reporting postoperative major anal incontinence; it seems to open an interesting way in the treatment of anal fistula. PMID:23729353

Cariati, Andrea

2013-06-02

340

Arteriovenous fistula of the internal maxillary artery in a child: case report  

Microsoft Academic Search

Direct arteriovenous fistulae supplied by the external carotid artery are unusual. Rarely, congenital fistulae have been described involving the head and neck. We describe the first case of congenital internal maxillary arteriovenous fistula in a child. Balloon embolization is currently considered the method of choice for treatment of direct arteriovenous fistula.

P. Cluzel; L. Pierot; M. Jason; M. Rose; E. Kieffer; J. Chiras

1992-01-01

341

Nasal and Vaginal Vaccinations Have Differential Effects on Antibody Responses in Vaginal and Cervical Secretions in Humans  

PubMed Central

Sexually transmitted diseases are a major health problem worldwide, but there is still a lack of knowledge about how to induce an optimal immune response in the genital tract of humans. In this study we vaccinated 21 volunteers nasally or vaginally with the model mucosal antigen cholera toxin B subunit and determined the level of specific immunoglobulin A (IgA) and IgG antibodies in vaginal and cervical secretions as well as in serum. To assess the hormonal influence on the induction of antibody responses after vaginal vaccination, we administered the vaccine either independently of the stage in the menstrual cycle or on days 10 and 24 in the cycle in different groups of subjects. Vaginal and nasal vaccinations both resulted in significant IgA and IgG anti-cholera toxin B subunit responses in serum in the majority of the volunteers in the various vaccination groups. Only vaginal vaccination given on days 10 and 24 in the cycle induced strong specific antibody responses in the cervix with 58-fold IgA and 16-fold IgG increases. In contrast, modest responses were seen after nasal vaccination and in the other vaginally vaccinated group. Nasal vaccination was superior in inducing a specific IgA response in vaginal secretions, giving a 35-fold increase, while vaginal vaccination induced only a 5-fold IgA increase. We conclude that a combination of nasal and vaginal vaccination might be the best vaccination strategy for inducing protective antibody responses in both cervical and vaginal secretions, provided that the vaginal vaccination is given on optimal time points in the cycle.

Johansson, Eva-Liz; Wassen, Lotta; Holmgren, Jan; Jertborn, Marianne; Rudin, Anna

2001-01-01

342

Vaginal and Oral Epithelial Cell Anti-Candida Activity  

Microsoft Academic Search

Candida albicans is the causative agent of acute and recurrent vulvovaginal candidiasis (VVC), a common mucosal infection affecting significant numbers of women in their reproductive years. While any murine host protective role for cell-mediated immunity (CMI), humoral immunity, and innate resistance by neutrophils against the vaginal infection appear negligible, significant in vitro growth inhibition of Candida species by vaginal and

Fatema Nomanbhoy; Chad Steele; Junko Yano

2002-01-01

343

Efficacy and tolerability of fitostimoline (vaginal cream, ovules, and vaginal washing) and of benzydamine hydrochloride (tantum rosa vaginal cream and vaginal washing) in the topical treatment of symptoms of bacterial vaginosis.  

PubMed

Two hundred and 91 patients showing signs and symptoms of bacterial vaginosis (BV) were randomized to receive topical treatment with Fitostimoline (vaginal cream and vaginal ovules + vaginal washing) or benzydamine hydrochloride (vaginal cream + vaginal washing) for 7 days. Signs (leucorrhoea, erythema, oedema, and erosion) and symptoms (burning, pain, itching, vaginal dryness, dyspareunia, and dysuria) (scored 0-3) were evaluated at baseline and at the end of treatment; the total symptoms score (TSS) was also calculated. In 125 patients, a bacterial vaginosis was confirmed by vaginal swab test. The primary efficacy variable analysis, that is, the percentage of patients with therapeutic success (almost complete disappearance of signs and symptoms), demonstrated that Fitostimoline ovules and vaginal cream were therapeutically equivalent and that pooled Fitostimoline treatment was not inferior to benzydamine hydrochloride. All the treatments were well tolerated, with only minor local adverse events infrequently reported. The results of this study confirmed that gynaecological Fitostimoline is a safe and effective topical treatment for BV. PMID:23209922

Boselli, F; Petrella, E; Campedelli, A; Muzi, M; Rullo, V; Ascione, L; Papa, R; Saponati, G

2012-10-30

344

Septate uterus associated with cervical duplication and vaginal septum  

Microsoft Academic Search

A woman had an unusual müllerian anomaly with a septate uterus, cervical duplication, and longitudinal vaginal septum. Gynecologists should be aware of the possibility of cervical duplication associated with uterine septum and not didelphic uterus, as this disorder in a patient with infertility or recurrent miscarriages can be treated surgically by resection of the uterine and vaginal septum. Embryologic explanations

Juan L. Giraldo; Antonia Habana; Antoni J. Duleba; Anuja Dokras

2000-01-01

345

Variation in vaginal breech delivery rates by hospital type  

Microsoft Academic Search

Objective: To relate vaginal breech delivery rates to the following hospital types: public, health maintenance organization, private teaching, or private nonteaching.Methods: In a retrospective study using administrative discharge data from Los Angeles County, California, we calculated the vaginal breech delivery rates of singleton breech deliveries during calendar years 1988 and 1991.Results: Ten thousand four hundred breech deliveries were identified, 8988

Kimberly D Gregory; Lisa M Korst; Michael Krychman; Patricia Cane; Lawrence D Platt

2001-01-01

346

Predictors of episiotomy use at first spontaneous vaginal delivery  

Microsoft Academic Search

Objective: To identify factors associated with the use of episiotomy at spontaneous vaginal delivery.Methods: We studied 1576 consecutive term, singleton, spontaneous vaginal deliveries in nulliparas at Brigham & Women’s Hospital between December 1, 1994 and July 31, 1995. The association of demographic variables and obstetric factors with the rate of episiotomy use were examined. Adjusted odds ratios (OR) and confidence

Julian N Robinson; Errol R Norwitz; Amy P Cohen; Ellice Lieberman

2000-01-01

347

Vaginal Eroticism and Female Orgasm: A Current Appraisal  

Microsoft Academic Search

In the light of very recent studies, this paper reviews two controversial issues in the area of female sexuality: vaginal eroticism and female orgasm. From the available evidence, it is concluded that most (and probably all) women possess vaginal zones, mainly located on the anterior wall, whose tactile stimulation can lead to orgasm. The apparent contradiction between this finding and

Heli Alzate

1985-01-01

348

[Physicopharmaceutical characteristics of ulinastatin vaginal suppositories prepared in a hospital].  

PubMed

We studied a locally applied vaginal preparation (vaginal suppositories) of ulinastatin (urinary trypsin inhibitor, UTI), designed to threatened premature delivery and maintain pregnancy. Witepsol S55 was chosen as the basic component of the vaginal suppositories based on the physical pharmaceutical characteristics of three kinds of hard fats. The average particle size of the UTI aqueous injection was approximately 70% as compared with that of the UTI lyophilized product, used as the base material for the preparation of UTI vaginal suppositories. We compared the physical pharmaceutical properties of UTI vaginal suppositories with water contents of 2.5%, 5.0%, and 7.5%, respectively. Preparation strength negatively correlated with the water content. The coefficient of viscosity positively correlated with the water content of the preparation. UTI vaginal suppositories with a water content of 5.0% had the highest average drug release rate on moment analysis. A comprehensive evaluation of the properties of UTI vaginal suppositories, including high strength due to disintegration resistance, the coefficient of viscosity and its influence on local retention, and drug release and its influence on the duration of effect, indicated that a 5.0% UTI aqueous solution for injection combined with Witepsol S55 as the base was the optimal formulation for the hospital preparation of vaginal suppositories. PMID:22041703

Satake, Kiyoshi; Nakajima, Takanori; Iwata, Masanori; Fujikake, Yoshio; Kimura, Masayuki

2011-01-01

349

Two cases of vaginal bleeding in pet rats  

PubMed Central

Two unrelated rats were presented to the Western College of Veterinary Medicine emergency service for vaginal bleeding. Each was taken to surgery due to marked blood loss and suspicion of uterine pathology. Despite similar clinical presentation, gross and histopathologic examination revealed 2 different underlying disease processes, uterine dilatation with mild endometritis and vaginal polyp.

Sadar, Miranda J.; Parker, Dennilyn L.; Burgess, Hilary; Wojnarowicz, Chris

2011-01-01

350

Two cases of vaginal bleeding in pet rats.  

PubMed

Two unrelated rats were presented to the Western College of Veterinary Medicine emergency service for vaginal bleeding. Each was taken to surgery due to marked blood loss and suspicion of uterine pathology. Despite similar clinical presentation, gross and histopathologic examination revealed 2 different underlying disease processes, uterine dilatation with mild endometritis and vaginal polyp. PMID:22210942

Sadar, Miranda J; Parker, Dennilyn L; Burgess, Hilary; Wojnarowicz, Chris

2011-07-01

351

Vaginal birth after cesarean among women with gestational diabetes  

Microsoft Academic Search

Objective: We sought to determine the pregnancy and infant outcomes of women with gestational diabetes who attempted vaginal birth after previous cesarean delivery. Study Design: We conducted a retrospective cohort study to compare women with gestational diabetes with matched control subjects without diabetes who attempted vaginal birth after cesarean at Grady Memorial Hospital, Atlanta, from January 1, 1989, through December

Traci L. Coleman; Hugh Randall; William Graves; Michael Lindsay

2001-01-01

352

Vaginal hygiene and douching: perspectives of Hispanic men  

Microsoft Academic Search

Vaginal douching is widely practised by women in the USA, particularly among minority ethnic groups, and is associated with increased risk of pelvic and vaginal infections. Douching practices are shaped by social and cultural norms regarding female hygiene, reproduction and sexuality. Little previous research has addressed the beliefs and practices of Latina women and none has included the perspective of

Diane McKee; María Baquero; Matthew Anderson; Alison Karasz

2009-01-01

353

EVALUATION OF VAGINAL IMPLANT TRANSMITTERS IN ELK (CERVUS ELAPHUS NELSONI)  

Microsoft Academic Search

The effects of vaginal implant transmitters for tissue damage after 11 wk in 13 captive adult elk (Cervus elaphus nelsoni) and subsequent reproductive performance in 38 free-ranging elk were evaluated. Vaginal implant transmitters are designed to be shed at parturition and are used to locate birth sites of wild ungulates; however, potential adverse effects of these transmitters on tissues associated

Bruce K. Johnson; Terrance McCoy; Christopher O. Kochanny; Rachel C. Cook

2006-01-01

354

Predictive score for vaginal birth after cesarean section  

Microsoft Academic Search

OBJECTIVE: Our purpose was to evaluate the relative weight of the different variables that may influence the chances of vaginal birth after one cesarean delivery, with the aim of developing a predictive score for success of such a trial. STUDY DESIGN: In this retrospective study, which covered a 10-year period (1981 to 1990), 471 women who attempted vaginal birth at

Daniel Weinstein; Abraham Benshushan; Vasilios Tanos; Ronit Zilberstein; Nathan Rojansky

1996-01-01

355

Why cobacterial infection in candida vaginitis is uncommon?  

Microsoft Academic Search

An interesting observation is that cobacterial infection in candida vaginitis is rare, while coinfection between other types\\u000a of vaginitis is common. The author hereby tried to explain this fact by the theory of internal alcoholic production as a cause.

Viroj Wiwanitkit

2008-01-01

356

Carotico-cavernous fistula: An educational case?  

PubMed Central

INTRODUCTION We present a case of direct carotico-cavernous fistula (CCF) and its successful treatment. PRESENTATION OF CASE A 55-year-old male presented with left eye discomfort, diplopia and pulsatile tinnitus. He had a recent history of head injury. Examination showed proptosis, chemosis, orbital bruit, and abducens nerve palsy. Digital subtraction angiography confirmed CCF, which was managed endovascularly. The patient recovered fully after treatment. DISCUSSION CCF has a variety of presenting clinical signs, imaging manifestations, and treatment options available. CONCLUSION CCF is a rare and dangerous neurological disorder that should be promptly diagnosed and treated.

Martin, Sean; Teo, Mario; Bhattacharya, Jo; Alakandy, Likhith

2013-01-01

357

Isolated arterioportal fistula presenting with variceal hemorrhage  

PubMed Central

We report a case of life-threatening hematemesis due to portal hypertension caused by an isolated arterioportal fistula (APF). Intrahepatic APFs are extremely rare and are a cause of presinusoidal portal hypertension. Etiologies for APFs are comprised of precipitating trauma, malignancy, and hereditary hemorrhagic telangiectasia, but these were not the case in our patient. Idiopathic APFs are usually due to congenital vascular abnormalities and thus usually present in the pediatric setting. This is one of the first cases of adult-onset isolated APF who presented with portal hypertension and was successfully managed through endoscopic hemostasis and subsequent interventional radiological embolization.

Nookala, Anupama; Saberi, Behnam; Ter-Oganesyan, Ramon; Kanel, Gary; Duong, Phillip; Saito, Takeshi

2013-01-01

358

Procured abortion in Ilorin, Nigeria.  

PubMed

A prospective study of the maternal mortality and morbidity and other related social problems among 144 cases of procured abortion in Ilorin, Nigeria over a 24-month period is presented. A mortality rate of 90.3 per thousand procured abortions was recorded. Genital sepsis, haemorrhagic anaemia, gut injury, uterine perforation and vesico vaginal fistulae (VVF) were encountered. Poor referral system, late presentation, poor blood transfusion services and inadequate availability of drugs had adverse effects on the patients. The implications (the menace and frequency) of these and possible measures like improving the literacy level, the moral standards, contraceptive practice and family life education (sex education) are discussed. PMID:7498012

Anate, M; Awoyemi, O; Oyawoye, O; Petu, O

1995-06-01

359

The medical ethics of the 'father of gynaecology', Dr J Marion Sims.  

PubMed Central

Vesico-vaginal fistula (VVF) was a common ailment among American women in the 19th century. Prior to that time, no successful surgery had been developed for the cure of this condition until Dr J Marion Sims perfected a successful surgical technique in 1849. Dr Sims used female slaves as research subjects over a four-year period of experimentation (1845-1849). This paper discusses the controversy surrounding his use of powerless women and whether his actions were acceptable during that historical period.

Ojanuga, D

1993-01-01

360

The role of fomites in the transmission of vaginitis.  

PubMed Central

A role for fomites such as toilet seats in the transmission of vaginitis has never been proved or disproved. A compilation of clinical data from a university community showed that the organisms found in vaginal cultures of patients with vaginitis were, in order of frequency. Candida albicans, Escherichia coli, beta-hemolytic streptococci, Hemophilus vaginalis and Trichomonas vaginalis. In a concurrent bacteriologic survey of washroom fixtures, staphylococci and other micrococci were isolated most frequently. The overt pathogens associated with vaginitis were never found, and gram-negative organisms appeared to be suppressed by the disinfectant used by the cleaning staff. It is clear that fomites are not an important mode of transmission in vaginitis, although a search for specific pathogens on toilets is to be continued.

Andrew, D. E.; Bumstead, E.; Kempton, A. G.

1975-01-01

361

Vaginal Cleansing Practices in HIV Infected Zambian Women  

PubMed Central

Vaginal practices are a variety of behavioral techniques that women use to manage their sexual life and personal hygiene. Women perceive vaginal practices as a beneficial practice. However, vaginal cleansing has been identified as one of the main risk factors for bacterial vaginosis and is potentially implicated in Human Immune Deficiency Virus (HIV) and sexually transmitted infection transmission. This study examined the prevalence of vaginal practices and the types of practices used among a sample of HIV positive women living in Lusaka, Zambia. Over 90% of all women recruited engaged in vaginal practices. Certain practices, such as use of water or soap, were more frequently used for hygiene reasons. Herbs and traditional medicines were mainly used to please sexual partner. Strategies to decrease VP appear urgently needed in the Zambian community.

Alcaide, Maria L.; Mumbi, Miriam; Chitalu, Ndashi; Jones, Deborah

2013-01-01

362

Vaginal Primary Malignant Melanoma: A Rare and Aggressive Tumor  

PubMed Central

Vaginal primary malignant melanoma is a rare and very aggressive tumor. It most commonly occurs in postmenopausal women, with a mean age of 57 years. Our patient is an 80-year-old, postmenopausal Greek woman presented with a complaint of abnormal vaginal bleeding. On gynecologic examination there was a pigmented, raised, ulcerated, and irregular lesion 5 × 4.5?cm in the upper third of anterior vaginal wall. She underwent a wide local excision of the lesion. The histopathology revealed vaginal primary malignant melanoma with ulceration and no clear surgical margins. She denied any additional surgical interventions and underwent to postoperative adjuvant radiotherapy. Follow up 5 months after initial diagnosis revealed no evidence of local recurrence or distant metastasis. The prognosis of vaginal primary malignant melanoma is very poor despite treatment modality, because most of the cases are diagnosed at advanced stage. Particularly patients with no clear surgical margins and tumor size >3?cm needed postoperative adjuvant radiotherapy.

Terzakis, Emmanouil; Ioannidou, Georgia; Tsamandas, Athanasios; Decavalas, Georgios

2013-01-01

363

Vaginal breech delivery: results of a prospective registration study  

PubMed Central

Background Most countries recommend planned cesarean section in breech deliveries, which is considered safer than vaginal delivery. As one of few countries in the western world Norway has continued to practice planned vaginal delivery in selected women. The aim of this study is to evaluate prospectively registered neonatal and maternal outcomes in term singleton breech deliveries in a Norwegian hospital during a ten years period. We aim to compare maternal and neonatal outcomes in term breech pregnancies subjected either to planned vaginal or elective cesarean section. Methods A prospective registration study including 568 women with term breech deliveries (>37 weeks) consecutively registered at Sorlandet Hospital Kristiansand between 2001 and 2011. Fetal and maternal outcomes were compared according to delivery method; planned vaginal delivery versus planned cesarean section. Results Of 568 women, elective cesarean section was planned in 279 (49%) cases and vaginal delivery was planned in 289 (51%) cases. Acute cesarean section was performed in 104 of the planned vaginal deliveries (36.3%). There were no neonatal deaths. Two cases of serious neonatal morbidity were reported in the planned vaginal group. One infant had seizures, brachial plexus injury, and cephalhematoma. The other infant had 5-minutes Apgar?vaginal group (10.0%) and eight in the planned cesarean section group (2.9%) (p?vaginal delivery group (p?vaginal group without long-term sequelae.

2013-01-01

364

Vaginal Health: Insights, Views & Attitudes (VIVA) survey - Canadian cohort.  

PubMed

OBJECTIVE: To evaluate knowledge of vaginal atrophy among postmenopausal women (aged 55-65 years), using the Vaginal Health: Insights, Views & Attitudes (VIVA) survey. METHODS: An independent research organization conducted a quantitative Internet-based survey, to obtain information from 3520 women who were living in the UK, the USA, Canada, Sweden, Denmark, Finland or Norway. Findings from Canada are presented (n = 500). RESULTS: Almost half of Canadian respondents had experienced vaginal discomfort since they had stopped menstruating, most commonly (88%) vaginal dryness; over half (56%) reported having experienced symptoms for three years or longer. Seven percent would have attributed vaginal symptoms to vaginal atrophy. Eighty-two percent of women felt that vaginal discomfort would have a negative impact on various aspects of their lives, most notably sexual intimacy (72%), 'having a loving relationship with a partner' (39%) and 'overall quality of life' (30%). While the majority of women (66%) who had experienced vaginal atrophy eventually sought the assistance of a health-care professional, a considerable proportion (34%) did not. Most women (58%) had tried lubricating gels and creams to treat their symptoms, but many were less aware of specific means of treating the underlying cause. However, compared with systemic hormone replacement therapy, more women indicated that they would consider local estrogen therapy (e.g. vaginal tablets or creams). CONCLUSIONS: These data indicate that many postmenopausal women in Canada have a low understanding of vaginal atrophy. Medical practitioners should proactively initiate dialogue about this chronic condition with their patients, and discuss appropriate treatment options. PMID:23201626

Frank, Sheldon M; Ziegler, Cleve; Kokot-Kierepa, Marta; Maamari, Ricardo; Nappi, Rossella E

2012-11-30

365

Vaginal microbial flora analysis by next generation sequencing and microarrays; can microbes indicate vaginal origin in a forensic context?  

PubMed

Forensic analysis of biological traces generally encompasses the investigation of both the person who contributed to the trace and the body site(s) from which the trace originates. For instance, for sexual assault cases, it can be beneficial to distinguish vaginal samples from skin or saliva samples. In this study, we explored the use of microbial flora to indicate vaginal origin. First, we explored the vaginal microbiome for a large set of clinical vaginal samples (n?=?240) by next generation sequencing (n?=?338,184 sequence reads) and found 1,619 different sequences. Next, we selected 389 candidate probes targeting genera or species and designed a microarray, with which we analysed a diverse set of samples; 43 DNA extracts from vaginal samples and 25 DNA extracts from samples from other body sites, including sites in close proximity of or in contact with the vagina. Finally, we used the microarray results and next generation sequencing dataset to assess the potential for a future approach that uses microbial markers to indicate vaginal origin. Since no candidate genera/species were found to positively identify all vaginal DNA extracts on their own, while excluding all non-vaginal DNA extracts, we deduce that a reliable statement about the cellular origin of a biological trace should be based on the detection of multiple species within various genera. Microarray analysis of a sample will then render a microbial flora pattern that is probably best analysed in a probabilistic approach. PMID:22282153

Benschop, Corina C G; Quaak, Frederike C A; Boon, Mathilde E; Sijen, Titia; Kuiper, Irene

2012-01-27

366

A novel material in seton treatment of fistula-in-ano  

Microsoft Academic Search

Fistula-in-ano is a common surgical problem. Various materials have been used to perform the seton technique in the treatment of fistula-in-ano. In this study, a novel material, a self-locking cable tie, was used regardless of the fistula type. Seventeen consecutive patients with anal fistula underwent surgery with the cutting seton technique using the novel material. Nine patients had high fistulas.

Ahmet Gurer; Nuraydin Ozlem; Ali Kagan Gokakin; Mehmet Ozdogan; Hakan Kulacoglu; Raci Aydin

2007-01-01

367

Low rate of fistula formation after Sommerlad palatoplasty with or without lateral incisions: an analysis of risk factors for formation of fistulas after palatoplasty.  

PubMed

The aim of palate repair is to restore normal eating and drinking function and normal speech development and still maintain undisturbed facial growth. The repair should be performed with a low frequency of complications. A number of factors are thought to contribute to the formation of fistulas after palatoplasty; they include patient factors and treatment issues. The aim of this study was to review all patients operated on with palatoplasties according to Sommerlad in our clinic, examine the fistula frequency and analyse risk factors for the development of fistulas after palate repair. During the study period, 175 patients were operated on with palatoplasties according to Sommerlad by the senior cleft surgeon. The group included 150 native patients and 25 adopted children. In the native population, seven patients developed fistulas and the fistula frequency was thus 5%. In the non-native group four patients developed fistulas, which gave a fistula frequency of 16%. In conclusion, the fistula frequency after Sommerlad repair of cleft palate is low in our material and few patients need fistula repair. The liberal usage of Langenbeck flaps might give a lower fistula rate. The most common place for fistulas is the junction of the soft and hard palate. No clear difference could be seen between different types of clefts. Syndromes and associated malformation seem to play a small role in the formation of fistulas. The fistula frequency in the non-native population is higher. A number of factors are different in the non-native population. PMID:23462210

Becker, Magnus; Hansson, Emma

2013-02-23

368

Endovascular Treatment of Tentorial Dural Arteriovenous Fistulae  

PubMed Central

Summary Tentorial dural arteriovenous fistula (DAVF) is a rare vascular disease, which accounts for less than 4% of all cases of intracranial DAVF. Because of the high risk of intracranial hemorrhage, patients with tentorial DAVF need aggressive treatment. Management approaches are still controversial, and endovascular treatment has emerged as an effective alternative. In the current work, we describe our experience with the endovascular approach in the treatment of these deep and complex DAVF of the tentorium. Eight patients were treated between January 2006 and July 2009. Six patients (75%) presented with intracranial hemorrhage related to the DAVF rupture. Four patients (50%) had subarachnoid bleeding and two had intraparenchymal hematoma. Endovascular treatment was performed via the transarterial route alone in five cases (62.5%), by the transvenous approach in two cases (25.0%) and in a combined procedure using both arterial and venous routes in one patient (12.5%). Complete obliteration of the fistula was achieved in all cases. The outcome at 15 months was favorable (modified Rankin scale 0-3) in seven (87.5%) patients. Complete cure of the lesion was confirmed in these cases. This paper reports on the effectiveness of endovascular treatment in tentorial DAVF management. The choice of the venous versus the arterial approach is determined by regarding different anatomical dispositions.

Wajnberg, E.; Spilberg, G.; Rezende, M.T.; Abud, D.G; Kessler, I.; Mounayer, C.

2012-01-01

369

Perilymph Fistula: Fifty Years of Controversy  

PubMed Central

Perilymph fistula (PLF) is defined as a leak of perilymph at the oval or round window. It excludes other conditions with “fistula” tests due to a dehiscent semi circular canal from cholesteatoma and the superior canal dehiscence syndrome. It was first recognized in the early days of stapedectomy as causing disequilibrium and balance problems before sealing of the stapedectomy with natural tissue became routine. It then became apparent that head trauma and barotraumatic trauma from flying or diving could be a cause of PLF. Descriptions of “spontaneous” PLF with no trauma history followed. A large literature on PLF from all causes accumulated. It became an almost emotional issue in Otolaryngology with “believers” and “nonbelievers.” The main criticisms are a lack of reliable symptoms and diagnostic tests and operative traps in reliably distinguishing a perilymph leak from local anaesthetic. There are extensive reviews on the whole topic, invariably conveying the authors' own experiences and their confirmed views on various aspects. However, a close examination reveals a disparity of definitions and assumptions on symptoms, particularly, vestibular. This is an intentionally provocative paper with suggestions on where some progress might be made.

Hornibrook, Jeremy

2012-01-01

370

Cutaneous bronchobiliary fistula treated with Tissucol sealant.  

PubMed

Bronchobiliary fistula is a rare and is an uncommon but severe complication of hydatid disease of the liver. Treatment has traditionally been surgical resection, but embolization and stent placement have been described. The invasive method seems to be a key component of patient treatment. We describe a case of a 58-year-old woman who, 25 years before, had undergone surgery for a hydatid cyst. A total cystectomy without previous puncture or parasite extraction was carried out. The lower aspect of the cyst was found to be completely perforated over the biliary duct. During the postoperative course, the patient had subphrenic right-sided pleural effusion and biliary fistula that subsided with medical treatment. Afterward, the patient came to the outpatient area of our hospital complaining of leakage of purulent exudate through the cutaneous opening, pain located on the right hypochondrium radiating to the right hemithorax, malaise, fever, chronic cough, and occasional vomiting of bile. Fistulography revealed an anfractuous cavity communicating with a residual cystic cavity on the right hepatic lobe. We observed communication with the intrahepatic canaliculi. Computed tomographic scan revealed a fistulous tract on the anterior liver border through the abdominal wall. There were no posttreatment complications. The patient is asymptomatic. PMID:20130874

Prieto-Nieto, M I; Pérez-Robledo, J P; Alvarez-Luque, A; Suz, J I Acitores; Torres, J Novo

2010-02-04

371

Treatment of pancreatic cutaneous fistulas with a somatostatin analog.  

PubMed

Five pancreatic cutaneous fistulas were treated by subcutaneous administration of a long-acting synthetic analog of somatostatin, SMS 201-995. Patients included four men and one woman who ranged in age from 52 to 77 years. The fistulas developed after drainage of a pancreatic abscess, biopsy of a pancreatic mass, splenectomies for idiopathic thrombocytopenic purpura and Felty's syndrome, and operative trauma, respectively. Fistula output consisted of 1,000 ml/day of amylase- and lipase-rich fluid in the patient with a pancreatic biopsy. The other four patients had low-output fistulas (100 to 250 ml/day) that had been draining for 1 to 12 months. Direct communication with the pancreatic duct was demonstrated by endoscopic retrograde cholangiopancreatography, sinography, or both in four of the five patients. Fistula output decreased from 340 +/- 376 ml/day to 63 +/- 36 ml/day on the first day of therapy with two daily doses of 0.05 mg SMS 201-995 (p less than 0.03) and to 13 +/- 19 ml/day on the seventh day of therapy (p less than 0.03). Two patients had prompt closure of their fistulas and one closed in 3 months. One patient with chronic pancreatitis and a duct stricture and one patient with recurring infection did not achieve permanent fistula closure with SMS 201-995. Because of its safety, ease of administration, and efficacy in decreasing fistula output, we believe somatostatin analog therapy is beneficial in hastening closure of pancreatic fistulas. PMID:2893556

Prinz, R A; Pickleman, J; Hoffman, J P

1988-01-01

372

Interscapular pharyngocutaneous fistula: an extreme complication of cervical stabilization surgery.  

PubMed

Pharyngeal and esophageal perforations are rare during cervical spine surgery but can cause significant morbidity. Pharyngeal or eosephageal perforations can occur by several mechanisms and the management of pharyngeal or eosephageal perforation's treatment may become difficult. We report a 41-year-old paraplegic man with an interscapular pharyngocutaneous fistula secondary to cervical vertebral surgery. The diagnosis of posterior fistula was delayed for several months as it was an extremely rare complication. We explored the anterior neck and repaired the perforation on the right pyriform sinus primarily. The fistula tract on the back of the patient was completely healed and the patient started oral feeding in the second week after surgery. PMID:23756986

Korkmaz, Hakan; Saylam, Guleser; Bayir, Omer; Tatar, Emel Cadalli; Ozdek, Ali

2013-01-01

373

Rectocutaneous fistula with imperforate anus in an adult.  

PubMed

Adult presentation of a rectocutaneous fistula with imperforate anus is rare. We report the case of a 22-year-old man who presented with an anorectal malformation and a rectocutaneous fistula. The patient complained of faecal matter passing through the external orifis of a fistula located at the distal part of his scrotum. He was continent for solid faeces, but had leakage of flatus and faecal soiling. He had no other associated anomaly. The patient subsequently underwent a surgical procedure where anal transposition was done. Postoperative recovery was uneventful, and the patient was fully continent at control examination. PMID:23624461

Duman, Kazim; Ozdemir, Yavuz; Yigitler, Cengizhan; Gulec, Bülent

2013-04-01

374

Posttransplant bilioportal fistula with portal vein thrombosis: a case report.  

PubMed

An 8-year-old female patient, known to have post-Kasai biliary atresia with mild intrapulmonary shunting, underwent living donor liver transplantation because of recurrent cholangitis. After the treatment of postoperative biliary stricture with percutaneous transhepatic biliary drainage, the patient subsequently developed hematochezia with portal vein thrombosis. The intraoperative findings showed portal vein thrombosis with a bilioportal fistula. We performed closure of the bilioportal fistula and reconstruction of the portal vein with a native internal jugular vein interposition graft. A bilioportal fistula due to percutaneous hepatobiliary procedures is a reportedly a rare complication following liver transplantation. The patient is currently doing well after a successful surgical intervention. PMID:21094871

Kasahara, M; Sakamoto, S; Fukuda, A; Shigeta, T; Tanaka, H; Mastuno, N; Hashimoto, M; Kondo, Y; Nosaka, S; Nakazawa, A

2010-11-01

375

Repair of salivary fistula after reconstruction of pharyngoesophagus  

SciTech Connect

We describe three surgical methods used to repair salivary fistulas in different situations that are seen after reconstruction of the pharyngoesophagus in patients with hypopharyngeal cancer. The principle of these methods is the same; a cervical skin flap next to the fistula is used as the internal lining and an anterior chest skin flap is rotated as an external lining to cover it. For the primary closure of heavily irradiated fistulas, this combination may not always be effective, and we emphasize that a combined use of a pedicled pectoralis major muscle flap with these two kinds of pedicled skin flap is extremely reliable.

Murakami, Y.; Ikari, T.; Haraguchi, S.; Okada, K.; Maruyama, T.; Tateno, H.

1988-07-01

376

Crohn's disease associated with colo-bronchial fistula.  

PubMed

An 18-year-old female patient with Crohn's disease presented with left lower lobe pneumonia and pleural effusion which were resistant to treatment with antibiotics. Colo-bronchial fistula had not been recognized until she coughed up yellow sputa with feculent odor and developed acute respiratory distress syndrome. This type of fistula is a rare complication of Crohn's disease, but the present case certainly alerts physicians to search for a fistula between the bronchus and gastrointestinal tract when encountering patients with Crohn's disease accompanied by antibiotic-resistant chronic pneumonia. PMID:9030994

Mera, A; Sugimoto, M; Fukuda, K; Tanaka, F; Imamura, F; Matsuda, M; Ando, M; Shima, K

1996-12-01

377

Treatment of postoperative enterocutaneous fistulas with octreotide in two neonates.  

PubMed

Enterocutaneous fistula (EF) in newborns and prematures is a well-recognized complication after necrotizing enterocolitis and other abdominal surgical procedures. Conservative management consists of bowel rest, antibiotics, wound care, and the administration of drugs that either reduce gastrointestinal motility or secretions. Octreotide decreases gastrointestinal secretions, inhibits or blocks the effects of gastrointestinal hormones, diminishes gut motility and thus reduces the flow through the fistula. We used octreotide and were able to report successful spontaneous closure of a fistula in our 2 neonatal patients, one a premature neonate with necrotizing enterocolitis (NEC) and the other with meconium peritonitis. PMID:18302073

Karabulut, R; Karaku?, C; Hirfano?lu, I; Turan, O; Türkyilmaz, Z; Sönmez, K; Onal, E E; Atalay, Y; Ba?aklar, A C

2008-02-01

378

Iatrogenic arteriovenous fistula of the superficial temporal artery  

Microsoft Academic Search

Introduction  The temporal artery courses superficially over the temporal bone and thus can be vulnerable to trauma. Although traumatic\\u000a lacerations of this vessel are indeed common, trauma-induced arteriovenous fistulae involving the temporal artery are relatively\\u000a rare. Arteriovenous fistulae caused by iatrogenic injury to the temporal artery are rarer still.\\u000a \\u000a \\u000a \\u000a Discussion and conclusion  We report a case of an ateriovenous fistula involving the

Grzegorz Miekisiak; Maciej Mis; Adam Sandler; Adam Druszcz

2008-01-01

379

Challenges and management of high-flow arteriovenous fistulae.  

PubMed

The Kidney Dialysis Outcomes Quality Initiative and Fistula First Initiative have embraced the arteriovenous fistula as the gold standard for hemodialysis accesses. Despite this status, fistulae are fraught with complex issues ranging from a high primary failure rate to high flow resulting in increased cardiovascular morbidity. It is important not to overlook the insidious peril of a hyperfunctioning access that may actively promote cardiac overload, cardiopulmonary recirculation, rapid access growth with aneurysm enlargement, recurrent venous stenosis resulting in access failure, and inflow/outflow mismatch. Once recognized, flow can and should be reduced to mitigate these and other negative effects. PMID:23217334

Miller, Gregg A; Hwang, Wayne W

2012-11-01

380

A comparison of abdominal and vaginal hysterectomies in Benghazi, Libya.  

PubMed

We performed a comparative study between abdominal and vaginal hysterectomies using clinical data from Al-Jamhouria hospital (one of the largest maternity hospitals in Eastern Libya). Various parameters were taken into consideration: the rates of each type (and their subtypes); average age of patients; indications; causes; postoperative complications; and duration of stay in the hospital afterwards. Conclusions and recommendations were drawn from the results of this study. In light of the aforementioned parameters, it was found that: (1) abdominal hysterectomies were more common than vaginal hysterectomies (p < 0.001); (2) patients admitted for abdominal hysterectomies are younger than those admitted for vaginal hysterectomies (p < 0.001); (3) the most common indication for an abdominal hysterectomy was menstrual disturbances, while for vaginal hysterectomies it was vaginal prolapse; (4) the histopathological cause for abdominal and vaginal hysterectomies were observed and the most common were found to be leiomyomas and atrophic endometrium; (5) there was no significant difference between the two routes in terms of postoperative complications; (6) patients who were admitted for abdominal hysterectomies spent a longer amount of time in the hospital (p < 0.01). It was concluded that efforts should be made to further pursue vaginal and laparoscopic hysterectomies as a viable option to the more conventional abdominal route. PMID:23919862

Agnaeber, K; Bodalal, Z

2013-08-01

381

[Post hysterectomy vaginal vault prolapse: diagnosis prevention and treatment].  

PubMed

Post-hysterectomy vaginal vault prolapse is a common disorder which generally manifests as a protrusion of the vagina through the genital hiatus, sometimes accompanied by urinary and gastrointestinal symptoms as well as sexual dysfunction. Risk factors for this condition include vaginal deliveries, obesity and previous hysterectomy, although genetic predisposition leading to reduced connective tissue and muscle strength may also play a role. Surgical correction of this disorder can be performed through either the abdominal or transvaginal approaches. Two prospective randomized trials have compared these approaches demonstrating better anatomic success rates for the abdominal approach as opposed to faster recovery and lower morbidity for the transvaginal approach. Laparoscopic and other transvaginal minimal access techniques for vaginal vault suspension have recently been advocated utilizing synthetic or biological adjuvant grafts. These techniques have been associated with high success rates albeit substantial graft complications such as erosion, contraction and dyspareunia. Suspension of the vaginal apex to the uterosacral ligaments (McCall culdoplasty) or to the sacrospinous ligaments at the time of vaginal hysterectomy is the mainstay for prevention of post hysterectomy vaginal vault prolapse. Our knowledge of the pathophysiology of post hysterectomy vaginal vault prolapse is quickly being refined, leading to more efficient surgical therapies for prevention and treatment of this disorder. PMID:18770962

Segev, Yakir; Auslander, Ron; Lavie, Ofer; Lissak, Arie; Abramov, Yoram

2008-05-01

382

When is a new fistula mature? The emerging science of fistula cannulation.  

PubMed

Once an arteriovenous fistula is established, the blood vessels are subjected to marked changes in hemodynamic forces that trigger remodeling to re-establish baseline parameters of sheer and hoop stress. These homeostatic processes culminate in two requirements that define an adequate and enduring access. First, blood flow must increase to provide amounts that will provide adequate delivery of blood to the artificial kidney. Second, the vessel wall must undergo changes that will allow it to withstand repeated cannulation. Hence, a fistula is mature when it can do what it sets out to do (flow readiness) despite what is being done to it (cannulation readiness). Although flow has been measured with Doppler, high-frequency ultrasound is needed to measure vessel wall thickness to determine hoop stress. Beyond the wall of the vessel, the concept of cannulation readiness depends on the skill and expertise of the cannulator. PMID:23217337

Donnelly, Sandra M; Marticorena, Rosa M

2012-11-01

383

Performing vaginal lavage, crystal violet staining, and vaginal cytological evaluation for mouse estrous cycle staging identification.  

PubMed

A rapid means of assessing reproductive status in rodents is useful not only in the study of reproductive dysfunction but is also required for the production of new mouse models of disease and investigations into the hormonal regulation of tissue degeneration (or regeneration) following pathological challenge. The murine reproductive (or estrous) cycle is divided into 4 stages: proestrus, estrus, metestrus, and diestrus. Defined fluctuations in circulating levels of the ovarian steroids 17-?-estradiol and progesterone, the gonadotropins luteinizing and follicle stimulating hormones, and the luteotropic hormone prolactin signal transition through these reproductive stages. Changes in cell typology within the murine vaginal canal reflect these underlying endocrine events. Daily assessment of the relative ratio of nucleated epithelial cells, cornified squamous epithelial cells, and leukocytes present in vaginal smears can be used to identify murine estrous stages. The degree of invasiveness, however, employed in collecting these samples can alter reproductive status and elicit an inflammatory response that can confound cytological assessment of smears. Here, we describe a simple, non-invasive protocol that can be used to determine the stage of the estrous cycle of a female mouse without altering her reproductive cycle. We detail how to differentiate between the four stages of the estrous cycle by collection and analysis of predominant cell typology in vaginal smears and we show how these changes can be interpreted with respect to endocrine status. PMID:23007862

McLean, Ashleigh C; Valenzuela, Nicolas; Fai, Stephen; Bennett, Steffany A L

2012-09-15

384

Performing Vaginal Lavage, Crystal Violet Staining, and Vaginal Cytological Evaluation for Mouse Estrous Cycle Staging Identification  

PubMed Central

A rapid means of assessing reproductive status in rodents is useful not only in the study of reproductive dysfunction but is also required for the production of new mouse models of disease and investigations into the hormonal regulation of tissue degeneration (or regeneration) following pathological challenge. The murine reproductive (or estrous) cycle is divided into 4 stages: proestrus, estrus, metestrus, and diestrus. Defined fluctuations in circulating levels of the ovarian steroids 17-?-estradiol and progesterone, the gonadotropins luteinizing and follicle stimulating hormones, and the luteotropic hormone prolactin signal transition through these reproductive stages. Changes in cell typology within the murine vaginal canal reflect these underlying endocrine events. Daily assessment of the relative ratio of nucleated epithelial cells, cornified squamous epithelial cells, and leukocytes present in vaginal smears can be used to identify murine estrous stages. The degree of invasiveness, however, employed in collecting these samples can alter reproductive status and elicit an inflammatory response that can confound cytological assessment of smears. Here, we describe a simple, non-invasive protocol that can be used to determine the stage of the estrous cycle of a female mouse without altering her reproductive cycle. We detail how to differentiate between the four stages of the estrous cycle by collection and analysis of predominant cell typology in vaginal smears and we show how these changes can be interpreted with respect to endocrine status.

McLean, Ashleigh C.; Valenzuela, Nicolas; Fai, Stephen; Bennett, Steffany A.L.

2012-01-01

385

Pathogenesis of urinary tract infection —experimental studies of vaginal resistance to colonization  

Microsoft Academic Search

The review summarizes studies of vaginal colonization resistance againstEscherichia coli in a primate model. The genital flora surrounding the urethral orifice exerts a strong colonization resistance. Amoxicillin profoundly disturbs the normal vaginal microflora, reduces its adherence to vaginal epithelial cells in vivo and promotes a persistent vaginalE. coli colonization. Certain cephalosporins may have a similar effect. The induced ecological changes

Jan Winberg; Maria Herthelius-Elman; Roland Miillby; Carl Erik Nord

1993-01-01

386

Magnitude of Interfractional Vaginal Cuff Movement: Implications for External Irradiation  

SciTech Connect

Purpose: To quantify the extent of interfractional vaginal cuff movement in patients receiving postoperative irradiation for cervical or endometrial cancer in the absence of bowel/bladder instruction. Methods and Materials: Eleven consecutive patients with cervical or endometrial cancer underwent placement of three gold seed fiducial markers in the vaginal cuff apex as part of standard of care before simulation. Patients subsequently underwent external irradiation and brachytherapy treatment based on institutional guidelines. Daily megavoltage CT imaging was performed during each external radiation treatment fraction. The daily positions of the vaginal apex fiducial markers were subsequently compared with the original position of the fiducial markers on the simulation CT. Composite dose-volume histograms were also created by summing daily target positions. Results: The average ({+-} standard deviation) vaginal cuff movement throughout daily pelvic external radiotherapy when referenced to the simulation position was 16.2 {+-} 8.3 mm. The maximum vaginal cuff movement for any patient during treatment was 34.5 mm. In the axial plane the mean vaginal cuff movement was 12.9 {+-} 6.7 mm. The maximum vaginal cuff axial movement was 30.7 mm. In the craniocaudal axis the mean movement was 10.3 {+-} 7.6 mm, with a maximum movement of 27.0 mm. Probability of cuff excursion outside of the clinical target volume steadily dropped as margin size increased (53%, 26%, 4.2%, and 1.4% for 1.0, 1.5, 2.0, and 2.5 cm, respectively.) However, rectal and bladder doses steadily increased with larger margin sizes. Conclusions: The magnitude of vaginal cuff movement is highly patient specific and can impact target coverage in patients without bowel/bladder instructions at simulation. The use of vaginal cuff fiducials can help identify patients at risk for target volume excursion.

Ma, Daniel J. [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Michaletz-Lorenz, Martha [Department of Education and Training, Elekta, Maryland Heights, MO (United States); Goddu, S. Murty [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Grigsby, Perry W., E-mail: pgrigsby@wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States); Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (United States)

2012-03-15

387

Vaginal intercourse frequency and heart rate variability.  

PubMed

We examined the relationship between recalled and diary recorded frequency of penile-vaginal intercourse (FSI) and both resting heart rate variability (HRV; an index of cardiac autonomic control and parasympathetic tone associated with cardiovascular health outcomes) and resting diastolic blood pressure (DBP) in 120 healthy adults aged 19-38 (subjects scoring above the 87th percentile on the Lie scale of the Eysenck Personality Inventory were excluded from analyses). As in a previous smaller study, greater HRV was associated with greater FSI (but not masturbation or non-coital sex with a partner) and rated importance of intercourse. There were no sex differences in the HRV-FSI relationship, and the relationship was not explained by including measures of Extraversion, Neuroticism, Depression, Trait Anxiety, or partnership satisfaction. However, the previously obtained negative association of FSI with DBP was not replicated. PMID:14504008

Brody, Stuart; Preut, Ragnar

388

Temporal Dynamics of the Human Vaginal Microbiota  

PubMed Central

Elucidating the factors that impinge on the stability of bacterial communities in the vagina may help in predicting the risk of diseases that affect women’s health. Here, we describe the temporal dynamics of the composition of vaginal bacterial communities in 32 reproductive age women over a 16-week period. The analysis revealed the dynamics of five major classes of bacterial communities and showed that some communities change markedly over short time periods, whereas others are relatively stable. Modeling community stability using new quantitative measures indicates that deviation from stability correlates with time in the menstrual cycle, bacterial community composition and sexual activity. The women studied are healthy, thus it appears that neither variation in community composition per se, nor higher levels of observed diversity (co-dominance) are necessarily indicative of dysbiosis, in which there is microbial imbalance accompanied by symptoms.

Gajer, Pawel; Brotman, Rebecca M.; Bai, Guoyun; Sakamoto, Joyce; Schutte, Ursel M.E.; Zhong, Xue; Koenig, Sara S.K.; Fu, Li; Ma, Zhanshan; Zhou, Xia; Abdo, Zaid; Forney, Larry J.; Ravel, Jacques

2012-01-01

389

Improving Vaginal Examinations Performed by Midwives  

PubMed Central

A vaginal examination (VE) is an essential part of midwifery care, and is routinely performed when assessing the progress of labour. As evidence shows that during labour women may find VEs unpleasant, embarrassing and sometimes painful, the aim of this article is to review literature on the use of VEs during labour and to synthesise information from the available literature on how to provide an effective VE. The studies considered were retrieved from three databases (the Cumulative Index to Nursing and Allied Health Literature [CINAHL], SCOPUS and MEDLINE) using the following search terms: “VEs in labour”, “midwives and use of VEs” and “women experiences of VEs in labour”. The literature reviewed suggests that midwives are not careful about VEs. Therefore, a concerted effort is needed to pay attention to the frequency of VEs, the management of pain and distress, information-giving and the preferences of the patient, so that the patient can feel in control during a VE.

Muliira, Rhoda S.; Seshan, Vidya; Ramasubramaniam, Shanthi

2013-01-01

390

Nickerson's Medium in the Diagnosis of Vaginal Moniliasis  

PubMed Central

One thousand one hundred and ninety-four cultures for vaginal moniliasis were performed on 1034 patients, using Nickerson's medium, to confirm the simplicity of the procedure and to demonstrate the inaccuracy of clinical impressions when compared to culture results. The error in the diagnosis of vaginal moniliasis on clinical impression and the wet-smear technique was as great as 60% when compared to the results of culture. The method employing this medium is easily adapted to routine office use, and offers an accurate and convenient means of diagnosis. The overall incidence of vaginal moniliasis in the variety of clinical groups studied was 21.3%.

O'Brien, J. R.

1964-01-01

391

Vaginal microbiome and sexually transmitted infections: an epidemiologic perspective  

PubMed Central

Vaginal bacterial communities are thought to help prevent sexually transmitted infections. Bacterial vaginosis (BV) is a common clinical syndrome in which the protective lactic acid–producing bacteria (mainly species of the Lactobacillus genus) are supplanted by a diverse array of anaerobic bacteria. Epidemiologically, BV has been shown to be an independent risk factor for adverse outcomes including preterm birth, development of pelvic inflammatory disease, and acquisition of sexually transmitted infections. Longitudinal studies of the vaginal microbiome using molecular techniques such as 16S ribosomal DNA analysis may lead to interventions that shift the vaginal microbiota toward more protective states.

Brotman, Rebecca M.

2011-01-01

392

Therapeutic Mechanisms of Treatment in Cervical and Vaginal Cancer  

PubMed Central

Cervical and vaginal cancers remain serious health problems. Worldwide, more than 530,000 women annually are diagnosed with these diseases, with most new incident cases occurring in nations with limited health resources and underdeveloped screening programs. For women whose disease is too bulky or widespread for surgery, radiochemotherapy should be looked upon as the standard of care. Randomized clinical trials have indicated that radiochemotherapy strategies that disrupt the repair of damaged DNA are key to the management of advanced stage cervical and vaginal cancers. Here, from a viewpoint of cancer cell molecular biology, treatments for advanced stage cervical and vaginal cancers are discussed.

Kunos, Charles A

2012-01-01

393

Childbirth experiences of women with obstetric fistula in Tanzania and Uganda and their implications for fistula program development  

Microsoft Academic Search

Introduction and hypothesis  Authors sought evidence from the testimonies of women living with fistula regarding local risk factors for fistula and the\\u000a impact of fistula on women's lives.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  One hundred thirty-seven women recruited from health facilities and at the community level in Tanzania and Uganda were interviewed\\u000a using quantitative and qualitative methods, including participatory approaches.\\u000a \\u000a \\u000a \\u000a \\u000a Results  Women of all ages and parities

Maggie Bangser; Manisha Mehta; Janet Singer; Chris Daly; Catherine Kamugumya; Atuswege Mwangomale

2011-01-01

394

Complex dural arteriovenous fistula in Bannayan-Riley-Ruvalcaba syndrome.  

PubMed

In this paper the authors report the case of a complex dural arteriovenous fistula (dAVF) with high-risk features in a 14-year-old girl with Bannayan-Riley-Ruvalcaba syndrome (BRRS), a phosphatase and tensin homolog-associated syndrome, presenting with signs and symptoms of increased intracranial pressure (ICP) that had previously been attributed to pseudotumor cerebri. This fistula was obliterated following 2 stages of embolization, and the patient experienced immediate symptomatic improvement. At the 2-month follow-up evaluation, the fistula remained angiographically occluded, and her symptoms continue to improve. This is the third reported case of an intracranial dAVF in a patient with BRRS. Because high-risk dAVFs can result in devastating morbidity, early detection with vascular imaging is crucial for patients with BRRS presenting with signs of increased ICP. Goals of treatment should include complete fistula obliteration whenever possible. PMID:23662932

Moon, Karam; Ducruet, Andrew F; Crowley, R Webster; Klas, Kathleen; Bristol, Ruth; Albuquerque, Felipe C

2013-05-10

395

Rectovesical fistula treated by covered self-expanding prosthesis  

Microsoft Academic Search

Postoperative rectovesical fistulas require surgical intervention for their treatment. We present a case treated by placement of a silicone self-expanding prosthesis in the rectum and vesical drainage and give technical details of the procedure.

R. Fernandez Lobato; I. Pinto; C. Maillo; L. Paul; J. M. Fradejas; M. Moreno Azcoita

1999-01-01

396

Clinical and echocardiographic features of aorto-atrial fistulas  

PubMed Central

Aorto-atrial fistulas (AAF) are rare but important pathophysiologic conditions of the aorta and have varied presentations such as acute pulmonary edema, chronic heart failure and incidental detection of the fistula. A variety of mechanisms such as aortic dissection, endocarditis with pseudoaneurysm formation, post surgical scenarios or trauma may precipitate the fistula formation. With increasing survival of patients, particularly following complex aortic reconstructive surgeries and redo valve surgeries, recognition of this complication, its clinical features and echocardiographic diagnosis is important. Since physical exam in this condition may be misleading, echocardiography serves as the cornerstone for diagnosis. The case below illustrates aorto-left atrial fistula formation following redo aortic valve surgery with slowly progressive symptoms of heart failure. A brief review of the existing literature of this entity is presented including emphasis on echocardiographic diagnosis and treatment.

Ananthasubramaniam, Karthik

2005-01-01

397

Endovascular repair of an actively hemorrhaging aortoduodenal fistula.  

PubMed

Aortoenteric fistulae require urgent definitive intervention and traditionally carry a high mortality. We describe a patient who suffered a traumatic aortic dissection following an auto versus pedestrian collision. He underwent open fenestration of his infrarenal aorta and visceral resection, complicated by abdominal sepsis and enterocutaneous fistulae. One month later he developed massive hematemesis, and endoscopic examination revealed an aortoduodenal fistula. Due to an impassable abdominal wall, a stent-graft repair was performed. This report describes the successful use of endovascular techniques to achieve immediate hemostasis in an actively hemorrhaging aortoduodenal fistula. An endovascular approach provides a valuable option in settings where a hostile abdomen precludes the traditional open technique and may serve as a bridge to later definitive repair. PMID:17532604

Barleben, Andrew R; Baig, Mirza S; Kubaska, Stephen M; Fujitani, Roy M; Gordon, Ian A; Lane, John S

2007-05-29

398

Colocutaneous gastric fistula: a complication of percutaneous endoscopic gastrostomy  

Microsoft Academic Search

Gastrocolic fistula is a rare complication of percutaneous endoscopic gastrostomy. It is most frequently discovered after replacement of the gastrostomy tube. The symptoms are severe diarrhea, failure to thrive, recurrent Gram-negative pulmonary infections, and feculent vomiting.

B. S. Kierstead; A. Khan; E. Ruppert; R. Bobo

1991-01-01

399

Selective Embolization of Large Symptomatic Iatrogenic Renal Transplant Arteriovenous Fistula  

Microsoft Academic Search

We report on the successful treatment of hypertension by occlusion of a large iatrogenic renal transplant arteriovenous fistula\\u000a using detachable embolization coils with concomitant flow reduction by occlusion balloon in two patients.

Fay L. Barley; David Kessel; Tony Nicholson; Iain Robertson

2006-01-01

400

Selective Embolization of Large Symptomatic Iatrogenic Renal Transplant Arteriovenous Fistula  

SciTech Connect

We report on the successful treatment of hypertension by occlusion of a large iatrogenic renal transplant arteriovenous fistula using detachable embolization coils with concomitant flow reduction by occlusion balloon in two patients.

Barley, Fay L.; Kessel, David, E-mail: david.kessel@leedsth.nhs.uk; Nicholson, Tony [St. James University Hospital, Department of Radiology (United Kingdom); Robertson, Iain [Gartnaval Hospital, Department of Radiology (United Kingdom)

2006-12-15

401

Brachial plexus compression by an iatrogenic arteriovenous fistula  

Microsoft Academic Search

Summary  A case of left brachial plexus compression by an iatrogenic arteriovenous fistula was treated by detachable balloon technique\\u000a with immediate relief of pain. Good results on paresia were obtained in a few weeks.

J. G. Tebib; J. Bascoulergue; Ch. Dumontet; A. Paupert-Ravault; B. Prallet; F. Colson; M. Bouvier

1987-01-01

402

Selective Embolization of Large Symptomatic Iatrogenic Renal Transplant Arteriovenous Fistula  

Microsoft Academic Search

We report on the successful treatment of hypertension by occlusion of a large iatrogenic renal transplant arteriovenous fistula using detachable embolization coils with concomitant flow reduction by occlusion balloon in two patients.

Fay L. Barley; David Kessel; Tony Nicholson; Iain Robertson

2006-01-01

403

Endovascular treatment of carotid cavernous sinus fistula: A systematic review  

PubMed Central

Carotid cavernous sinus fistulas are abnormal communications between the carotid system and the cavernous sinus. Several classification schemes have described carotid cavernous sinus fistulas according to etiology, hemodynamic features, or the angiographic arterial architecture. Increased pressure within the cavernous sinus appears to be the main factor in pathophysiology. The clinical features are related to size, exact location, and duration of the fistula, adequacy and route of venous drainage and the presence of arterial/venous collaterals. Noninvasive imaging (computed tomography, magnetic resonance, computed tomography angiography, magnetic resonance angiography, Doppler) is often used in the initial work-up of a possible carotid cavernous sinus fistulas. Cerebral angiography is the gold standard for the definitive diagnosis, classification, and planning of treatment for these lesions. The endovascular approach has evolved as the mainstay therapy for definitive treatment in situations including clinical emergencies. Conservative treatment, surgery and radiosurgery constitute other management options for these lesions.

Korkmazer, Bora; Kocak, Burak; Tureci, Ercan; Islak, Civan; Kocer, Naci; Kizilkilic, Osman

2013-01-01

404

Traumatic Coronary Artery Fistula Closure with Stent Graft  

PubMed Central

We present a rare case of a symptomatic acquired large coronary fistula and aneurysm secondary to chest trauma that was successfully closed using stent graft. This case is followed by review of the literature.

Safi, Morteza; Ebrahim, Nematollah Pour; Namazi, Mohammad Hasan; Saadat, Habibollah; Vakili, Hosein; Hekmat, Manuchehr

2012-01-01

405

Sudden Onset and Blinding Spontaneous Direct Carotid-Cavernous Fistula  

PubMed Central

Purpose To report a case of spontaneous direct carotid-cavernous fistula causing abrupt loss of vision. Case Report A 50-year-old woman with systemic hypertension but no history of ocular disease developed sudden proptosis, frozen eye, subconjunctival hemorrhage and loss of vision in her left eye over 2 hours. Imaging studies revealed a direct carotid-cavernous fistula. Management for high intraocular pressure was promptly initiated and the patient was referred to a neurosurgery service, but she refused any surgical intervention. Ultimately, she accepted to undergo manual carotid artery compression which resulted in significant reduction in the proptosis, but she lost all vision permanently. Conclusion Direct carotid-cavernous fistula can occur spontaneously and should be taken into account in patients with signs suggestive of direct carotid-cavernous sinus fistula even without history of trauma or connective tissue disorder.

Razeghinejad, Mohammad-Reza; Tehrani, Mansooreh Jamshidian

2011-01-01

406

Oronasal fistula in cleft palate surgery  

PubMed Central

Oronasal fistula (ONF) is the commonest complication associated with cleft palate surgery. The main symptoms associated with ONF are nasal regurgitation of food matter and hypernasality of voice. Repair of cleft palate under tension is considered to be the main reason of ONF though vascular accidents and infection can also be the cause. Most of the ONFs are situated in the hard palate or at the junction of hard and soft palate. Repair of ONF depends on its site, size and mode of presentation. A whole spectrum of surgical procedures starting from small local flaps to microvascular tissue transfers have been employed for closure of ONF. Recurrence rate of ONF is 25% on an average after the first attempt of repair.

Sadhu, Partha

2009-01-01

407

Arterioportal Fistulas in Liver Transplant Recipients  

PubMed Central

Arterioportal fistulas (APFs) are classified into intrahepatic (>75% of all reported) and extrahepatic (<25% of all reported ). Anecdotally, investigators are more likely to report more sensational cases (typically extrahepatic APFs), so the actual prevalence of intrahepatic APFs is probably much higher (likely >90% of APFs). All reported APFs in liver transplant recipients have been intrahepatic. Hemodynamically significant APFs in liver transplant recipients are rare, occurring in 0.2%; however, APFs (hemodynamically significant or not) are not uncommonly seen in hepatic angiograms of liver transplant recipients (up to 5.4% of hepatic arteriograms in transplants). Interestingly, hemodynamically significant APFs warranting endovascular treatment are reported more commonly in the literature in native compared with transplanted livers (n >280–300 versus n?=?13, respectively). This article discusses APFs that are specific to liver transplant recipients; their incidence, etiology, pathogenesis, natural history, clinical presentation, and endovascular management are discussed in detail.

Saad, Wael E. A.

2012-01-01

408

Intravaginal and Intranasal Immunizations Are Equally Effective in Inducing Vaginal Antibodies and Conferring Protection against Vaginal Candidiasis  

PubMed Central

Oophorectomized, estrogen-treated rats were immunized by the intravaginal or intranasal route with a mannoprotein extract (MP) or secreted aspartyl proteinases (Sap) of Candida albicans, with or without cholera toxin as a mucosal adjuvant. Both routes of immunization were equally effective in (i) inducing anti-MP and anti-Sap vaginal antibodies and (ii) conferring a high degree of protection against the vaginal infection by the fungus. These data suggest that appropriate fungal antigens and adjuvant can be used to protect against candidal vaginitis, by either route.

De Bernardis, Flavia; Boccanera, Maria; Adriani, Daniela; Girolamo, Antonietta; Cassone, Antonio

2002-01-01

409

Intravaginal and intranasal immunizations are equally effective in inducing vaginal antibodies and conferring protection against vaginal candidiasis.  

PubMed

Oophorectomized, estrogen-treated rats were immunized by the intravaginal or intranasal route with a mannoprotein extract (MP) or secreted aspartyl proteinases (Sap) of Candida albicans, with or without cholera toxin as a mucosal adjuvant. Both routes of immunization were equally effective in (i) inducing anti-MP and anti-Sap vaginal antibodies and (ii) conferring a high degree of protection against the vaginal infection by the fungus. These data suggest that appropriate fungal antigens and adjuvant can be used to protect against candidal vaginitis, by either route. PMID:11953420

De Bernardis, Flavia; Boccanera, Maria; Adriani, Daniela; Girolamo, Antonietta; Cassone, Antonio

2002-05-01

410

Anatomy-based surgical strategy of gastrointestinal fistula treatment  

Microsoft Academic Search

Anatomic delineation of a gastrointestinal fistula is essential in assessing the likelihood of spontaneous closure or to plan\\u000a the surgical management. Computed tomography (CT) enterography and\\/or fistulograms provide invaluable information. The surgical\\u000a strategy should carefully consider the when and how, as well as the special clinical situations that may arise following radiotherapy,\\u000a the inaccessible or “frozen abdomen”, and enteroatmospheric fistulas

F. Turégano; A. García-Marín

2011-01-01

411

Spinal dural arteriovenous fistulas: a plea for neurosurgical treatment  

Microsoft Academic Search

Summary  Spinal dural arteriovenous fistulas are the most common type of arteriovenous malformation involving the spinal cord, especially\\u000a in middle-aged men. We report 21 patients with this malformation who had signs and symptoms of myelopathy. The diagnosis was\\u000a established by selective spinal angiography in patients whose neurological deficits, myelograms or magnetic resonance tomographies\\u000a suggested the presence of a spinal arteriovenous fistula.

B. C. Huffmann; J. M. Gilsbach; A. Thron

1995-01-01

412

Dementia caused by dural arteriovenous fistulas reversed following endovascular therapy  

PubMed Central

We describe two patients who presented with dementia as the primary neurological manifestation of their dural arteriovenous fistula (dAVF). Although dementia is not the most common presentation for a dAVF, these cases show that obliterating the fistula can eliminate this dreadful manifestation. This awareness may facilitate the diagnosis of dementia in cases caused by dAVF and allow for a minimally invasive treatment that restores cognitive function back to baseline.

Henderson, James B.; Hise, Joseph H.; Opatowsky, Michael J.; Layton, Kennith F.

2012-01-01

413

Tracheomediastinal Fistula Caused by Non-Hodgkin's Lymphoma.  

PubMed

Non-Hodgkin's lymphoma involving the tracheobronchial tree is uncommon. A 60-year-old man presented with severe cough for two months. Bronchoscopy disclosed an ulcerative lesion at the lower trachea and carina with anterior tracheomediastinal fistula, and biopsy revealed tracheal wall B-cell lymphoma. After chemo-radiotherapy, the tracheomediastinal fistula healed, but eight months later, tracheal stenosis was diagnosed by bronchoscopy. A self-expansible metallic stent was placed, which successfully maintained the airway. PMID:23603637

Huang, Chang-Lun; Chen, Heng-Chung; Huang, Hung-Che; Cheng, Ching-Yuan

2013-04-20

414

Predictors of adequacy of arteriovenous fistulas in hemodialysis patients  

Microsoft Academic Search

Predictors of adequacy of arteriovenous fistulas in hemodialysis patients.BackgroundDialysis access procedures and complications represent a major cause of morbidity, hospitalization, and cost for chronic dialysis patients. To improve the outcomes of hemodialysis access procedures, recent clinical guidelines have encouraged attempts to place an arteriovenous (A-V) fistula, rather than an A-V graft, whenever possible in hemodialysis patients. There is little information,

Paul E. Miller; Ashita Tolwani; C. Peter Luscy; Mark H. Deierhoi; Robert Bailey; David T. Redden; Michael Allon

1999-01-01

415

Ni(II) biosorption by Cassia fistula (Golden Shower) biomass  

Microsoft Academic Search

Cassia fistula is a fast-growing, medium-sized, deciduous tree which is now widely cultivated worldwide as an ornamental tree for its beautiful showy yellow flowers. Methods are required to reuse fallen leaves, branches, stem bark and pods when they start getting all over lawn. This investigation studies the use of these non-useful parts of C. fistula as naturally occurring biosorbent for

Muhammad Asif Hanif; Raziya Nadeem; Haq Nawaz Bhatti; Najum Rashid Ahmad; Tariq Mehmood Ansari

2007-01-01

416

Colon Interposition in Children after Failed Tracheoesophageal Fistula Repair  

PubMed Central

The most common surgical procedure used to manage tracheoesophageal fistula is the primary anastomosis of the esophagus. However, in the case of failed anastomosis, replacing the esophagus with another organ is necessary. We performed two procedures of colon interposition after failure of tracheoesophageal fistula repair. In those cases, stomach replacement was not possible because of a failed Ivor Lewis operation in one case and duodenal atresia in the other.

Park, Samina; Kim, Hye-Seon; Park, In Kyu; Kim, Young Tae; Kim, Joo-Hyun

2011-01-01

417

Cyanoacrylate glue in the treatment of ano-rectal fistulas  

Microsoft Academic Search

Background and aims  The management of anal fistula is debatable. Although several procedures have been described, none of them is free from complications, such as anal incontinence and anal pain. The purpose of this study was to evaluate the employment of a glue composed of N-butil-2-cyanoacrylate and methacryloxysulfolane (Glubran 2) to treat fistula-in-ano.Patients and methods  Twenty-one patients (14 men and 7 women)

Paolo Barillari; Luigi Basso; Antonella Larcinese; Paolo Gozzo; Marileda Indinnimeo

2006-01-01

418

Vesicovaginal Fistula and Ureteral Injury During Pelvic Surgery  

Microsoft Academic Search

Because of the proximity of the bladder and ureters to the uterus, iatrogenic injuries are a well-described complication of\\u000a gynecologic surgery. If unrecognized, complications such as vesicovaginal fistula (VVF) and ureterovaginal fistula (UVF) may\\u000a occur. VVF ranks as the second most common genitourinary tract injury, with the second highest cause of malpractice claims\\u000a (1,2). Given the morbidity suffered by the

Craig V. Comiter; Christina Escobar

419

[Swelling of the neck following tonsillectomy : Lateral cervical fistula.  

PubMed

A 16-year-old patient presented with recurrent cervical swelling to the right side of the neck on coughing and sneezing. Although present since childhood, the symptoms had progressed over the preceding year. Immediately prior to this period a bilateral tonsillectomy had been performed for recurrent tonsillitis. Magnetic resonance imaging revealed a complete lateral cervical fistula extending between the thyroid and submandibular glands on the right side of the neck. Successful surgical resection accomplished complete removal of the fistula. PMID:23515593

Klotz, L V; Reichel, O

2013-03-22

420

Multidisciplinary management of multiple spinal dural arteriovenous fistulae  

PubMed Central

Multiple SDAVFs are quite rare. We present two cases with double synchronous shunts and both were treated during one-stage interventional or surgical procedure. Unique images of the multiple SDAVFs as a PMAVF-like fistula were obtained. These interesting findings suggest the presence of multiple fistulas must be considered in patients being evaluated for SDAVF. A multidisciplinary approach to the management of multiple SDAVFs should depend on the anatomic location and angioarchitecture.

Ge, Liang; Feng, Rui; Zhang, Xiaolong; Sun, Bing; Gu, Shixin; Xu, Qiwu; Lu, Gang; Huang, Lei

2013-01-01

421

Balancing 'fistula first' with a 'catheter last' strategy.  

PubMed

Endovascular treatment, in general, is a safe and effective method to assist a fistula to maturation, although this does not mean that surgical revision is not better in some patients. An experienced interventionalist should be able to discern the most appropriate treatment modality based upon physical exam, duplex ultrasound, and/ or fistulogram. The care of a hemodialysis patient is truly a team endeavor, including the primary care physician, nephrologists, dialysis nurses and coordinators, and the interventionalists. Each must be aware that options exist to assist many slowly or non-maturing fistulas in order to establish a usable, functional fistula as soon as possible to limit the frequent complications associated with tunneled catheters. Even diffusely small veins are not beyond the reach of therapy as evidenced with the BAM procedure. Early evaluation following fistula placement (three to four weeks) with quick referral to an experienced interventionalist is crucial. There is emerging data suggesting that there is no negative effect on patency with early cannulation of fistulas, even as soon as one month. Perhaps in the near future we might see an even greater impact on the prevalence of tunneled catheters with the emergence of earlier cannulation of fistulas, along with more aggressive intervention to slowly maturing fistulas, such as the BAM procedure. As experience with the BAM procedure grows, there may be a role for BAM in patients with a suboptimal vein on preoperative vein mapping (< 2.5 mm). These patients, who traditionally would have received a prosthetic graft, might be candidates for fistula placement followed by a preplanned BAM, initiated within weeks of the initial placement. The cost effectiveness and utility of such a strategy is unstudied and would be a good subject for future trials. PMID:19534361

Fulton, Joseph J

2009-05-01

422

Spontaneous thrombosis of an iatrogenic arteriovenous fistula of the kidney  

Microsoft Academic Search

A 44-year-old woman underwent radial nephrotomy for a symptomatic stone in a caliceal diverticulum. Five days after an uneventful postoperative course of 1 week, she presented with gross hematuria. Routine ultrasound demonstrated a hypoechoic lesion in the kidney; color-coded sonography revealed an arteriovenous fistula. The hematuria ended before the scheduled angiography to embolize the fistula was performed. Repeated color-coded sonography

J. Miguel Garcia-Schürmann; Hans-Jörg Sommerfeld; Jürgen Pannek

2001-01-01

423

Endovascular Repair of Iatrogenic Superior Mesenteric Arteriovenous Fistula  

Microsoft Academic Search

Arteriovenous fistulas between the superior mesenteric artery and vein are extremely rare and often a late complication of bowel resection. We report a case of a 42-year-old male, who presented with abdominal pain and dyspnoea 9 years after ileo-caecal resection. A superior mesenteric arteriovenous fistula was detected and treated endovascularly with an Amplatzer Vascular Plug, thereby reducing the cardiac output

J. P. Eiberg; M. Bundgaard-Nielsen; M. A. Hansen; N. H. Secher

2009-01-01

424

A rare case of vaginal vault evisceration and its management  

PubMed Central

A 66 year old woman presented to A&E with per vagina bleeding and a mass protruding from the vagina. The patient was examined under anaesthesia, which revealed vaginal prolapse with evisceration of approximately 20-30 cm of bowel. The patient had received an abdominal hysterectomy 30 years ago for menorrhagia. In the last decade, the patient had experienced other recurrent episodes of prolapse (cystocoele and retrocoele). Vaginal vault evisceration is a recognised rare complication of hysterectomy and is a gynaecological emergency. This patient’s condition was rapidly recognised and surgically managed. The repair was achieved in two surgeries. Initially, the small bowel was re-inserted into the peritoneal cavity through the vaginal wall defect and the vaginal defect repaired. After sufficient time for healing, a sacrocolpopexy was performed to repair the prolapse.

Pereira, FD Alves; Rai, H

2012-01-01

425

Trichomoniasis as Seen in a Chronic Vaginitis Clinic  

PubMed Central

Objective: We sought to determine the clinical and laboratory features of trichomonas vaginitis (TV) in a chronic vaginitis clinic. Methods: We studied 45 women with symptomatic TV attending a specialty chronic vaginitis clinic. These patients were older than the usual symptomatic patients with TV. They frequently described unusual chronicity of symptoms, half being referred because of clinical resistance and the other half referred because of chronic vaginitis of unknown etiology. Results: In spite of the chronicity of infection, the signs and symptoms of florid inflammation were still evident and high numbers of polymorphonuclear leukocytes and parasitic load were present. Conclusions: A longstanding infection, especially if previously untreated, invariably responded to conventional nitroimidazole therapy. In addition, the majority of patients seen with clinical resistance to the conventional doses of metronidazole responded to high-dose oral metronidazole therapy. Unsuspected TV should always be considered in low-risk patients with chronic vulvovaginal symptoms.

Dan, Michael

1996-01-01

426

Moniliasis--The Use of Candicidin Vaginal Ointment for Treatment  

PubMed Central

Candicidin vaginal ointment, 0.14 mg per gm of petrolatum base, was used in the treatment of 25 patients with monilial vaginitis. Ten of these patients were pregnant. All 15 of the non-gravid patients were cured, as proved by repeated cultures, after a maximum of three weeks of therapy. Eight of the 10 gravid patients were cured. Of the two patients with resistant cases, one had severe diabetes and the other had endocervicitis. Of 50 patients treated by insertion of Candeptin vaginal tablets, 42 became free of vaginal moniliasis after one or two 14-day courses of home treatment. All 42 remained free of infection for one month following treatment, as proven by culture. There were no instances of sensitivity to the preparation.

Roberts, Chester L.; Sullivan, John J.

1965-01-01

427

Gynecologic bleeding revealing vaginal metastasis of renal cell carcinoma  

PubMed Central

Vaginal metastases of renal cell carcinoma have been rarely described. We report a case of a 75-year old woman, who underwent radical right nephrectomy for a renal cell carcinoma. Tumour was classified pT3bN0M0 and grade III of Furhmann grading. One year later, scanner discovered mediastinal and lombo-aortic lymph nodes. She received 2 months of immunotherapy associated with bevacizumab, but stopped because of intolerance. She was readmitted in our institute for vaginal bleeding. Clinical investigations showed a vaginal mass and biopsy revealed a renal cell carcinoma metastasis. This case suggests that retrograde venous dissemination may be at the origin of vaginal metastasis of renal cell carcinoma and emphasized the preventive value of early ligature of renal vein.

Benbrahim, Zineb; Chouaib, Ali; Mazeron, Renaud; Leger-Ravet, Marie Benedicte; Lefort, Catherine; Lhomme, Catherine; El Mesbahi, Omar; Escudier, Bernard

2013-01-01

428

Vaginal pH: Home-Use Tests  

MedlinePLUS

... type of test is this? This is a quantitative test -- you find out how acidic your vaginal ... Government For Press Combination Products Advisory Committees Science & Research Regulatory Information Safety Emergency Preparedness International Programs News & ...

429

Vaginal and Cervical Cytology of the Early Puerperium.  

National Technical Information Service (NTIS)

Cervical and vaginal smears were obtained from 160 women who had delivered one to eight days prior to cytologic examination. Preparations were examined for general morphology and graded for malignancy. The degree of cytologic abnormality was found to corr...

H. B. Soloway

1969-01-01

430

Conservative treatment of post-lobectomy bronchopleural fistula  

PubMed Central

Post-lobectomy bronchopleural fistula is a rare complication of lung resection surgery, and proper management is essential for its successful resolution. Most published papers deal with endoscopic and surgical treatment. We report our experience with conservative management. Data were collected by reviewing the clinical charts of patients diagnosed with post-lobectomy bronchopleural fistula at the University Hospitals Marqués de Valdecilla, Santander, and Puerta de Hierro, Majadahonda-Madrid, Spain, from June 2003 to December 2010. Bronchopleural fistula was diagnosed by means of endoscopic visualization. Treatment included the insertion of a thoracostomy drainage tube in the pleural cavity. In patients under mechanical ventilation, independent pulmonary ventilation was also applied. Seven cases of post-lobectomy bronchopleural fistula were collected. Three of them occurred within the first week, another three within the first month and the remaining case after 10 months. The fistula size ranged between 6 mm and complete suture dehiscence. Two patients died due to causes unrelated to the treatment. The period of time elapsed for the resolution of this complication varied between 5 and 36 days. We conclude that conservative treatment of post-lobectomy bronchopleural fistula is a safe and simple option that must be taken into account in the management of this problem.

Naranjo Gomez, Jose Manuel; Carbajo Carbajo, Miguel; Valdivia Concha, Daniel; Campo-Canaveral de la Cruz, Jose Luis

2012-01-01

431

Monitoring dialysis arteriovenous fistulae: it's in our hands.  

PubMed

Vascular access problems are a daily occurrence in hemodialysis units. Loss of patency of the vascular access limits hemodialysis delivery and may result in underdialysis that leads to increased morbidity and mortality. Despite the known superiority of autogenous fistulae over grafts, autogenous fistulae also suffer from frequent development of stenosis and subsequent thrombosis. International guidelines recommend programmes for detection of stenosis and consequent correction in an attempt to reduce the rate of thrombosis. Physical examination of autogenous fistulae has recently been revisited as an important element in the assessment of stenotic lesions. Prospective observational studies have consistently demonstrated that physical examination performed by trained physicians is an accurate method for the diagnosis of fistula stenosis and, therefore, should be part of all surveillance protocols of the vascular access. However, to optimize hemodialysis access surveillance, hemodialysis practitioners may need to improve their skills in performing physical examination. The purpose of this article is to review the basics and drawbacks of physical examination for dialysis arteriovenous fistulae and to provide the reader with its diagnostic accuracy in the detection of arteriovenous fistula dysfunction, based on current published literature. PMID:23599144

Coentrão, Luis; Turmel-Rodrigues, Luc

2013-04-18

432

[Traumatic coronary-cardiac fistulas. Apropos of a case].  

PubMed

The case of a 24-year old patient having suffered a bullet wound was reported. After a hemopericardium accompanied by minor signs of tamponade, a continuous murmur gradually appeared due to a fistula between the right coronary artery and the right atrium, which was strictly symptomless: surgical repair was performed eight years after the accident. This satisfactory spontaneous outcome, after surviving the life threatening danger of tamponade and myocardial infarction was also observed in the 21 cases of coronary-cardiac fistulae already published. The fistula, which almost always involves the right heart cavities, only gives rise to a continuous murmur which is often discovered at a later stage. The long term course of traumatic coronary-cardiac fistulae can only be assessed by comparison with congenital coronary-cardiac fistulae, which are much better known, and the consequences of which are on all accounts similar. Four complications are discussed: heart failure, coronary insufficiency, infectious endocarditis, and the rupture of the fistulized coronary artery due to aneurysmal dilatation. These risks are statistically small and more theoretical then real, and the justification of systematic repair of traumatic coronary-cardiac fistulae now rests essentially on the relatively low risk of the procedure. PMID:120152

Verneyre, H; Lamaud, M; Faure, F; Michaud, P

1979-12-01

433

Optimized Dose Distribution of Gammamed Plus Vaginal Cylinders  

SciTech Connect

Endometrial carcinoma is the most common malignancy arising in the female genital tract. Intracavitary vaginal cuff irradiation may be given alone or with external beam irradiation in patients determined to be at risk for locoregional recurrence. Vaginal cylinders are often used to deliver a brachytherapy dose to the vaginal apex and upper vagina or the entire vaginal surface in the management of postoperative endometrial cancer or cervical cancer. The dose distributions of HDR vaginal cylinders must be evaluated carefully, so that clinical experiences with LDR techniques can be used in guiding optimal use of HDR techniques. The aim of this study was to optimize dose distribution for Gammamed plus vaginal cylinders. Placement of dose optimization points was evaluated for its effect on optimized dose distributions. Two different dose optimization point models were used in this study, namely non-apex (dose optimization points only on periphery of cylinder) and apex (dose optimization points on periphery and along the curvature including the apex points). Thirteen dwell positions were used for the HDR dosimetry to obtain a 6-cm active length. Thus 13 optimization points were available at the periphery of the cylinder. The coordinates of the points along the curvature depended on the cylinder diameters and were chosen for each cylinder so that four points were distributed evenly in the curvature portion of the cylinder. Diameter of vaginal cylinders varied from 2.0 to 4.0 cm. Iterative optimization routine was utilized for all optimizations. The effects of various optimization routines (iterative, geometric, equal times) was studied for the 3.0-cm diameter vaginal cylinder. The effect of source travel step size on the optimized dose distributions for vaginal cylinders was also evaluated. All optimizations in this study were carried for dose of 6 Gy at dose optimization points. For both non-apex and apex models of vaginal cylinders, doses for apex point and three dome points were higher for the apex model compared with the non-apex model. Mean doses to the optimization points for both the cylinder models and all the cylinder diameters were 6 Gy, matching with the prescription dose of 6 Gy. Iterative optimization routine resulted in the highest dose to apex point and dome points. The mean dose for optimization point was 6.01 Gy for iterative optimization and was much higher than 5.74 Gy for geometric and equal times routines. Step size of 1 cm gave the highest dose to the apex point. This step size was superior in terms of mean dose to optimization points. Selection of dose optimization points for the derivation of optimized dose distributions for vaginal cylinders affects the dose distributions.

Supe, Sanjay S. [Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka (India)], E-mail: sanjayssupe@gmail.com; Bijina, T.K.; Varatharaj, C.; Shwetha, B.; Arunkumar, T.; Sathiyan, S.; Ganesh, K.M.; Ravikumar, M. [Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka (India)

2009-04-01

434

Optimized dose distribution of Gammamed plus vaginal cylinders.  

PubMed

Endometrial carcinoma is the most common malignancy arising in the female genital tract. Intracavitary vaginal cuff irradiation may be given alone or with external beam irradiation in patients determined to be at risk for locoregional recurrence. Vaginal cylinders are often used to deliver a brachytherapy dose to the vaginal apex and upper vagina or the entire vaginal surface in the management of postoperative endometrial cancer or cervical cancer. The dose distributions of HDR vaginal cylinders must be evaluated carefully, so that clinical experiences with LDR techniques can be used in guiding optimal use of HDR techniques. The aim of this study was to optimize dose distribution for Gammamed plus vaginal cylinders. Placement of dose optimization points was evaluated for its effect on optimized dose distributions. Two different dose optimization point models were used in this study, namely non-apex (dose optimization points only on periphery of cylinder) and apex (dose optimization points on periphery and along the curvature including the apex points). Thirteen dwell positions were used for the HDR dosimetry to obtain a 6-cm active length. Thus 13 optimization points were available at the periphery of the cylinder. The coordinates of the points along the curvature depended on the cylinder diameters and were chosen for each cylinder so that four points were distributed evenly in the curvature portion of the cylinder. Diameter of vaginal cylinders varied from 2.0 to 4.0 cm. Iterative optimization routine was utilized for all optimizations. The effects of various optimization routines (iterative, geometric, equal times) was studied for the 3.0-cm diameter vaginal cylinder. The effect of source travel step size on the optimized dose distributions for vaginal cylinders was also evaluated. All optimizations in this study were carried for dose of 6 Gy at dose optimization points. For both non-apex and apex models of vaginal cylinders, doses for apex point and three dome points were higher for the apex model compared with the non-apex model. Mean doses to the optimization points for both the cylinder models and all the cylinder diameters were 6 Gy, matching with the prescription dose of 6 Gy. Iterative optimization routine resulted in the highest dose to apex point and dome points. The mean dose for optimization point was 6.01 Gy for iterative optimization and was much higher than 5.74 Gy for geometric and equal times routines. Step size of 1 cm gave the highest dose to the apex point. This step size was superior in terms of mean dose to optimization points. Selection of dose optimization points for the derivation of optimized dose distributions for vaginal cylinders affects the dose distributions. PMID:19181251

Supe, Sanjay S; Bijina, T K; Varatharaj, C; Shwetha, B; Arunkumar, T; Sathiyan, S; Ganesh, K M; Ravikumar, M

2007-10-02

435

Surgical Repair of Ruptured Abdominal Aortic Aneurysm with Non-Bleeding Aortocaval Fistula  

PubMed Central

We present a case of an aortocaval fistula (ACF) without bleeding because a clot was covering the fistula. A 60-year-old man was diagnosed as having a ruptured abdominal aortic aneurysm (AAA) and an aortocaval fistula, by enhanced computed tomography (CT). After the aneurysm had been opened, the fistula was detected, but there was no bleeding because it was covered with clot. After graft repair, bleeding from the fistula occurred when the clot was removed by suction. Direct closure of the fistula was achieved after bleeding was controlled by digital compression.

2013-01-01

436

Female sexual dysfunction following vaginal surgery: Myth or reality?  

Microsoft Academic Search

This article reviews the mechanisms by which vaginal surgery affects female sexual function and related pathophysiology to\\u000a potential causes. The anatomy, neurovascular supply of the clitoris and introitus, and intrapelvic nerve supply are discussed\\u000a as they apply to vaginal surgery. Methods to avoid neurovascular damage during pelvic floor surgery have been corroborated\\u000a by supporting literature. The incidence of female sexual

Hari S. G. R. Tunuguntla; Angelo E. Gousse

2004-01-01

437

Embolisation of both fistulae through the same carotid artery tear in a patient with bilateral traumatic caroticocavernous fistulae  

Microsoft Academic Search

Endovascular treatment of traumatic caroticocavernous fistulae (CCF) may present technical difficulties with specific angiographic dilemmas. We report endovascular techniques used in a patient with bilateral post-traumatic CCF, high-flow on one side, and slow-flow on the other. Complete closure of both was achieved through the same carotid artery tear. To our knowledge, transarterial venous coil embolisation of a low-flow fistula through

I. Oran; H. Bozkaya; M. Parildar

2004-01-01

438

RASTREAMENTO DE CANDIDOSE VAGINAL DURANTE A PREVENÇÃO DO CÂNCER CÉRVICO-UTERINO SCREENING OF VAGINAL CANDIDOSIS DURING THE PREVENTION OF UTERINE CERVIX CANCER  

Microsoft Academic Search

Introduction: vaginal candidosis is one of the most prevalent infection of the lower genital tract around the world. Lately a huge increase in inciden- ce accounted for ranking this disease as the second more frequent vaginal infection in Brazil. These reasons led some authors to indicate the scree- ning of vaginal discharge in gynecology clinics. Objective: the aim of this

Vânia LN Cavalcante; Aldine T Miranda; Glenda MP Portugal

439

Phenotypic and Functional Characterization of Vaginal Dendritic Cells in a Rat Model of Candida albicans Vaginitis  

PubMed Central

This study analyzes the phenotype of vaginal dendritic cells (VDCs), their antigenic presentation and activation of T-cell cytokine secretion, and their protective role in a rat model of Candida vaginitis. Histological observation demonstrated a significant accumulation of OX62+ VDCs in the mucosal epithelium of Candida albicans-infected rats at the third round of infection. We identified two subsets of OX62+ VDCs differing in the expression of CD4 molecule in both noninfected and Candida-infected rats. The OX62+ CD4+ subset of VDCs displayed a lymphoid cell-like morphology and expressed the T-cell antigen CD5, whereas the OX62+ CD4? VDC subset exhibited a myeloid morphology and was CD5 negative. Candida infection resulted in VDC maturation with enhanced expression of CD80 and CD134L on both CD4+ and CD4? VDC subsets at 2 and 6 weeks after Candida infection. CD5? CD4? CD86? CD80? CD134L+ VDCs from infected, but not noninfected, rats spontaneously released large amounts of interleukin-12 (IL-12) and tumor necrosis factor alpha, whereas all VDC subsets released comparable levels of IL-10 and IL-2 cytokines. Furthermore, OX62+ VDCs from infected rats primed naïve CD4+ T-cell proliferation and release of cytokines, including gamma interferon, IL-2, IL-6, and IL-10, in response to staphylococcal enterotoxin B stimulation in vitro. Adoptive transfer of highly purified OX62+ VDCs from infected rats induced a significant acceleration of fungal clearance compared with that in rats receiving naive VDCs, suggesting a protective role of VDCs in the anti-Candida mucosal immunity. Finally, VDC-mediated protection was associated with their ability to rapidly migrate to the vaginal mucosa and lymph nodes, as assessed by adoptive transfer of OX62+ VDCs labeled with 5 (and 6-)-carboxyfluorescein diacetate succinimidyl ester.

De Bernardis, Flavia; Lucciarini, Roberta; Boccanera, Maria; Amantini, Consuelo; Arancia, Silvia; Morrone, Stefania; Mosca, Michela; Cassone, Antonio; Santoni, Giorgio

2006-01-01

440

Phenotypic and functional characterization of vaginal dendritic cells in a rat model of Candida albicans vaginitis.  

PubMed

This study analyzes the phenotype of vaginal dendritic cells (VDCs), their antigenic presentation and activation of T-cell cytokine secretion, and their protective role in a rat model of Candida vaginitis. Histological observation demonstrated a significant accumulation of OX62(+) VDCs in the mucosal epithelium of Candida albicans-infected rats at the third round of infection. We identified two subsets of OX62(+) VDCs differing in the expression of CD4 molecule in both noninfected and Candida-infected rats. The OX62(+) CD4(+) subset of VDCs displayed a lymphoid cell-like morphology and expressed the T-cell antigen CD5, whereas the OX62(+) CD4(-) VDC subset exhibited a myeloid morphology and was CD5 negative. Candida infection resulted in VDC maturation with enhanced expression of CD80 and CD134L on both CD4(+) and CD4(-) VDC subsets at 2 and 6 weeks after Candida infection. CD5(-) CD4(-) CD86(-) CD80(-) CD134L(+) VDCs from infected, but not noninfected, rats spontaneously released large amounts of interleukin-12 (IL-12) and tumor necrosis factor alpha, whereas all VDC subsets released comparable levels of IL-10 and IL-2 cytokines. Furthermore, OX62(+) VDCs from infected rats primed naïve CD4(+) T-cell proliferation and release of cytokines, including gamma interferon, IL-2, IL-6, and IL-10, in response to staphylococcal enterotoxin B stimulation in vitro. Adoptive transfer of highly purified OX62(+) VDCs from infected rats induced a significant acceleration of fungal clearance compared with that in rats receiving naive VDCs, suggesting a protective role of VDCs in the anti-Candida mucosal immunity. Finally, VDC-mediated protection was associated with their ability to rapidly migrate to the vaginal mucosa and lymph nodes, as assessed by adoptive transfer of OX62(+) VDCs labeled with 5 (and 6-)-carboxyfluorescein diacetate succinimidyl ester. PMID:16790803

De Bernardis, Flavia; Lucciarini, Roberta; Boccanera, Maria; Amantini, Consuelo; Arancia, Silvia; Morrone, Stefania; Mosca, Michela; Cassone, Antonio; Santoni, Giorgio

2006-07-01

441

Efficacy of Rifaximin Vaginal Tablets in Treatment of Bacterial Vaginosis: a Molecular Characterization of the Vaginal Microbiota  

PubMed Central

Bacterial vaginosis (BV) is a common vaginal disorder characterized by an alteration of the vaginal bacterial morphotypes, associated with sexually transmitted infections and adverse pregnancy outcomes. The purpose of the present study was to evaluate the impact of different doses of rifaximin vaginal tablets (100 mg/day for 5 days, 25 mg/day for 5 days, and 100 mg/day for 2 days) on the vaginal microbiota of 102 European patients with BV enrolled in a multicenter, double-blind, randomized, placebo-controlled study. An integrated molecular approach based on quantitative PCR (qPCR) and PCR-denaturing gradient gel electrophoresis (PCR-DGGE) was used to investigate the effects of vaginal tablets containing the antibiotic. An increase in members of the genus Lactobacillus and a decrease in the BV-related bacterial groups after the antibiotic treatment were demonstrated by qPCR. PCR-DGGE profiles confirmed the capability of rifaximin to modulate the composition of the vaginal microbial communities and to reduce their complexity. This molecular analysis supported the clinical observation that rifaximin at 25 mg/day for 5 days represents an effective treatment to be used in future pivotal studies for the treatment of BV.

Cruciani, Federica; Brigidi, Patrizia; Calanni, Fiorella; Lauro, Vittoria; Tacchi, Raffaella; Donders, Gilbert; Peters, Klaus; Guaschino, Secondo

2012-01-01

442

Efficacy of rifaximin vaginal tablets in treatment of bacterial vaginosis: a molecular characterization of the vaginal microbiota.  

PubMed

Bacterial vaginosis (BV) is a common vaginal disorder characterized by an alteration of the vaginal bacterial morphotypes, associated with sexually transmitted infections and adverse pregnancy outcomes. The purpose of the present study was to evaluate the impact of different doses of rifaximin vaginal tablets (100 mg/day for 5 days, 25 mg/day for 5 days, and 100 mg/day for 2 days) on the vaginal microbiota of 102 European patients with BV enrolled in a multicenter, double-blind, randomized, placebo-controlled study. An integrated molecular approach based on quantitative PCR (qPCR) and PCR-denaturing gradient gel electrophoresis (PCR-DGGE) was used to investigate the effects of vaginal tablets containing the antibiotic. An increase in members of the genus Lactobacillus and a decrease in the BV-related bacterial groups after the antibiotic treatment were demonstrated by qPCR. PCR-DGGE profiles confirmed the capability of rifaximin to modulate the composition of the vaginal microbial communities and to reduce their complexity. This molecular analysis supported the clinical observation that rifaximin at 25 mg/day for 5 days represents an effective treatment to be used in future pivotal studies for the treatment of BV. PMID:22585228

Cruciani, Federica; Brigidi, Patrizia; Calanni, Fiorella; Lauro, Vittoria; Tacchi, Raffaella; Donders, Gilbert; Peters, Klaus; Guaschino, Secondo; Vitali, Beatrice

2012-05-14

443

Vaginal intraepithelial neoplasia: a therapeutical dilemma.  

PubMed

Vaginal intraepithelial neoplasia (VaIN) represents a rare and asymptomatic pre-neoplastic lesion. Its natural history and potential evolution into invasive cancer are uncertain. VaIN can occur alone or as a synchronous or metachronous lesion with cervical and vulvar HPV-related intra epithelial or invasive neoplasia. Its association with cervical intraepithelial neoplasia is found in 65% of cases, with vulvar intraepithelial neoplasia in 10% of cases, while for others, the association with concomitant cervical or vulvar intraepithelial neoplasias is found in 30-80% of cases. VaIN is often asymptomatic and its diagnosis is suspected in cases of abnormal cytology, followed by colposcopy and colposcopically-guided biopsy of suspicious areas. In the past, high-grade VaIN and multifocal VaIN have been treated by radical surgery, such as total or partial upper vaginectomy associated with hysterectomy and radiotherapy. The need to maintain the integrity of reproductive capacity has determined the transition from radical therapies to conservative ones, according to the different patients' characteristics. PMID:23267125

Frega, Antonio; Sopracordevole, Francesco; Assorgi, Chiara; Lombardi, Danila; DE Sanctis, Vitaliana; Catalano, Angelica; Matteucci, Eleonora; Milazzo, Giusi Natalia; Ricciardi, Enzo; Moscarini, Massimo

2013-01-01

444

Species-level classification of the vaginal microbiome  

PubMed Central

Background The application of next-generation sequencing to the study of the vaginal microbiome is revealing the spectrum of microbial communities that inhabit the human vagina. High-resolution identification of bacterial taxa, minimally to the species level, is necessary to fully understand the association of the vaginal microbiome with bacterial vaginosis, sexually transmitted infections, pregnancy complications, menopause, and other physiological and infectious conditions. However, most current taxonomic assignment strategies based on metagenomic 16S rDNA sequence analysis provide at best a genus-level resolution. While surveys of 16S rRNA gene sequences are common in microbiome studies, few well-curated, body-site-specific reference databases of 16S rRNA gene sequences are available, and no such resource is available for vaginal microbiome studies. Results We constructed the Vaginal 16S rDNA Reference Database, a comprehensive and non-redundant database of 16S rDNA reference sequences for bacterial taxa likely to be associated with vaginal health, and we developed STIRRUPS, a new method that employs the USEARCH algorithm with a curated reference database for rapid species-level classification of 16S rDNA partial sequences. The method was applied to two datasets of V1-V3 16S rDNA reads: one generated from a mock community containing DNA from six bacterial strains associated with vaginal health, and a second generated from over 1,000 mid-vaginal samples collected as part of the Vaginal Human Microbiome Project at Virginia Commonwealth University. In both datasets, STIRRUPS, used in conjunction with the Vaginal 16S rDNA Reference Database, classified more than 95% of processed reads to a species-level taxon using a 97% global identity threshold for assignment. Conclusions This database and method provide accurate species-level classifications of metagenomic 16S rDNA sequence reads that will be useful for analysis and comparison of microbiome profiles from vaginal samples. STIRRUPS can be used to classify 16S rDNA sequence reads from other ecological niches if an appropriate reference database of 16S rDNA sequences is available.

2012-01-01

445

Pharyngocutaneous fistula onset after total laryngectomy: scintigraphic analysis.  

PubMed

Pharyngocutaneous fistula is the most common non-fatal complication following total laryngectomy. To start oral feeding and exclude the presence of a pharyngocutaneous fistula, a subjective test and instrumental assessments using videofluoroscopy, have been described. The aim of this study was to evaluate the effectiveness of oral-pharyngo-oesophageal scintigraphy as an objective and non-invasive tool to establish presence, site and dimensions of the fistula. Observations were performed on 3 male patients, mean age 65 years, who underwent total laryngectomy and mono or bilateral neck dissection after failure of radiotherapy in 2 cases and of conservative laryngeal surgery in the third case, complicated by post-operative pharyngocutaneous fistula. Oral-pharyngo-oesophageal scintigraphy dynamic study with sequential images were obtained during the swallowing phases. In case 1, the test showed a wide pharyngocutaneous fistula the internal orifice of which was at the level of the base of the tongue: on the scintigraphic images, the radiomarked water bolus, from the fistulous orifice, descended along the stoma walls and only a small part reached the oesophagus. In the other two patients, the pharyngocutaneous fistula was small and the internal fistulous orifice was detected in the lower part of T-suture line. In conclusion, scintigraphy offered the possibility to precisely identify presence of pharyngocutaneous fistula and location of its internal orifice and to monitor its spontaneous closure. Therefore, important information could be obtained regarding the suture line status and the possibility of deciding whether to remove the nasogastric tube or to leave it in place. Finally, these data showed that oral-pharyngo-oesophageal scintigraphy could be performed in the early post-operative period to optimize starting safe oral feeding. PMID:20162023

Galli, J; Valenza, V; Parrilla, C; Galla, S; Marchese, M R; Castaldi, P; Almadori, G; Paludetti, G

2009-10-01

446

Pharyngocutaneous fistula onset after total laryngectomy: scintigraphic analysis  

PubMed Central

Summary Pharyngocutaneous fistula is the most common non-fatal complication following total laryngectomy. To start oral feeding and exclude the presence of a pharyngocutaneous fistula, a subjective test and instrumental assessments using videofluoroscopy, have been described. The aim of this study was to evaluate the effectiveness of oral-pharyngo-oesophageal scintigraphy as an objective and non-invasive tool to establish presence, site and dimensions of the fistula. Observations were performed on 3 male patients, mean age 65 years, who underwent total laryngectomy and mono or bilateral neck dissection after failure of radiotherapy in 2 cases and of conservative laryngeal surgery in the third case, complicated by post-operative pharyngocutaneous fistula. Oral-pharyngo-oesophageal scintigraphy dynamic study with sequential images were obtained during the swallowing phases. In case 1, the test showed a wide pharyngocutaneous fistula the internal orifice of which was at the level of the base of the tongue: on the scintigraphic images, the radiomarked water bolus, from the fistulous orifice, descended along the stoma walls and only a small part reached the oesophagus. In the other two patients, the pharyngocutaneous fistula was small and the internal fistulous orifice was detected in the lower part of T-suture line. In conclusion, scintigraphy offered the possibility to precisely identify presence of pharyngocutaneous fistula and location of its internal orifice and to monitor its spontaneous closure. Therefore, important information could be obtained regarding the suture line status and the possibility of deciding whether to remove the nasogastric tube or to leave it in place. Finally, these data showed that oral-pharyngo-oesophageal scintigraphy could be performed in the early post-operative period to optimize starting safe oral feeding.

Galli, J; Valenza, V; Parrilla, C; Galla, S; Marchese, MR; Castaldi, P; Almadori, G; Paludetti, G

2009-01-01

447

Concurrent Chemoradiotherapy for Esophageal Cancer With Malignant Fistula  

SciTech Connect

Background: We reviewed clinical results of chemoradiotherapy (CRT) in the treatment of patients with advanced esophageal cancer with fistulae that developed before or during CRT. Methods and Materials: The study group included 16 patients with fistulous esophageal cancer treated by means of CRT between 1999 and 2006. Nine patients had fistulae before CRT, whereas 7 developed fistulae during CRT. The group included 12 men and four women with a median age of 55 years (range, 37-77 years). There were 9 patients with Stage III disease and 7 with Stage IV disease. All tumors were squamous cell carcinomas. Two courses of concurrent chemotherapy were combined with radiation therapy; 60 Gy/30 fractions/7 weeks (1-week split). For 15 patients, low-dose protracted chemotherapy with 5-fluorouracil (250-300 mg/m{sup 2} x 14 days) and cisplatin (7 mg/m{sup 2} x 10 days) was administered, whereas full-dose cisplatin and 5-fluorouracil were administered to the remaining patient. Results: The planned dose of 60 Gy was delivered to 11 patients (69%), whereas radiation therapy was terminated early in 5 patients (40-58 Gy) because of acute toxicities, including two treatment-related deaths. Disappearance of fistulae was noted during or after CRT in 7 patients (44%). All three esophagomediastinal fistulae were closed, but only four of 13 esophagorespiratory fistulae were closed by CRT. For patients with Stage III, 1- and 2-year survival rates were 33% and 22%, respectively. Median survival time was 8.5 months. Conclusion: Despite significant toxicity, concurrent CRT appears effective at closing esophageal malignant fistulae.

Koike, Ryuta [Department of Radiation Oncology, Kinki University School of Medicine, Osaka (Japan); Nishimura, Yasumasa [Department of Radiation Oncology, Kinki University School of Medicine, Osaka (Japan)], E-mail: ynishi@med.kindai.ac.jp; Nakamatsu, Kiyoshi; Kanamori, Shuichi; Shibata, Toru [Department of Radiation Oncology, Kinki University School of Medicine, Osaka (Japan)

2008-04-01

448

Reprinted article "Factors associated with early failure of arteriovenous fistulae for haemodialysis access".  

PubMed

The radiocephalic arteriovenous fistula remains the method of choice for haemodialysis access. In order to assess their suitability for fistula formation, the radial arteries and cephalic veins were examined preoperatively by ultrasound colour flow scanner in conjunction with a pulse-generated run-off system. Intraoperative blood flow was measured after construction of the fistulae. Post-operative follow-up was performed at various intervals to monitor the development of the fistulae. Radial artery and cephalic vein diameter less than 1.6 mm was associated with early fistula failure. The intraoperative fistula blood flow did not correlate with the outcome of the operation probably due to vessel spasm from manipulation. However, blood flow velocities measured non-invasively 1 day after the operation were significantly lower in fistulae that failed early compared with those that were adequate for haemodialysis. Most of the increase in fistula diameter and blood flow occur within the first 2 weeks of surgery. PMID:21855022

Wong, V; Ward, R; Taylor, J; Selvakumar, S; How, T V; Bakran, A

2011-09-01

449

Acid Production by Vaginal Flora In Vitro Is Consistent with the Rate and Extent of Vaginal Acidification  

PubMed Central

Perinatally, and between menarche and menopause, increased levels of estrogen cause large amounts of glycogen to be deposited in the vaginal epithelium. During these times, the anaerobic metabolism of the glycogen, by the epithelial cells themselves and/or by vaginal flora, causes the vagina to become acidic (pH ?4). This study was designed to test whether the characteristics of acid production by vaginal flora in vitro can account for vaginal acidity. Eight vaginal Lactobacillus isolates from four species—L. gasseri, L. vaginalis, L. crispatus, and L. jensenii—acidified their growth medium to an asymptotic pH (3.2 to 4.8) that matches the range seen in the Lactobacillus-dominated human vagina (pH 3.6 to 4.5 in most women) (B. Andersch, L. Forssman, K. Lincoln, and P. Torstensson, Gynecol. Obstet. Investig. 21:19–25, 1986; L. Cohen, Br. J. Vener. Dis. 45:241–246, 1969; J. Paavonen, Scand. J. Infect. Dis. Suppl. 40:31–35, 1983; C. Tevi-Bénissan, L. Bélec, M. Lévy, V. Schneider-Fauveau, A. Si Mohamed, M.-C. Hallouin, M. Matta, and G. Grésenguet, Clin. Diagn. Lab. Immunol. 4:367–374, 1997). During exponential growth, all of these Lactobacillus species acidified their growth medium at rates on the order of 106 protons/bacterium/s. Such rates, combined with an estimate of the total number of lactobacilli in the vagina, suggest that vaginal lactobacilli could reacidify the vagina at the rate observed postcoitally following neutralization by the male ejaculate (W. H. Masters and V. E. Johnson, Human sexual response, p. 93, 1966). During bacterial vaginosis (BV), there is a loss of vaginal acidity, and the vaginal pH rises to >4.5. This correlates with a loss of lactobacilli and an overgrowth of diverse bacteria. Three BV-associated bacteria, Gardnerella vaginalis, Prevotella bivia, and Peptostreptococcus anaerobius, acidified their growth medium to an asymptotic pH (4.7 to 6.0) consistent with the characteristic elevated vaginal pH associated with BV. Together, these observations are consistent with vaginal flora, rather than epithelial cells, playing a primary role in creating the acidity of the vagina.

Boskey, E. R.; Telsch, K. M.; Whaley, K. J.; Moench, T. R.; Cone, R. A.

1999-01-01

450

Leukocyte Esterase Activity in Vaginal Fluid of Pregnant and Non-Pregnant Women With Vaginitis/Vaginosis and in Controls  

PubMed Central

Objectives: To determine the leukocyte esterase (LE) activity in vaginal lavage fluid of women with acute and recurrent vulvovaginal candidosis (VVC and RVVC respectively), bacterial vaginosis (BV), and in pregnant and non-pregnant women without evidence of the three conditions. Also to compare the result of LE tests in women consulting at different weeks in the cycle and trimesters of pregnancy.The LE activity was correlated to vaginal pH, number of inflammatory cells in stained vaginal smears, type of predominating vaginal bacteria and presence of yeast morphotypes. Methods: One hundred and thirteen women with a history of RVVC, i.e. with at least four attacks of the condition during the previous year and who had consulted with an assumed new attack of the condition, were studied. Furthermore, we studied 16 women with VVC, 15 women with BV, and 27 women attending for control of cytological abnormalities, who all presented without evidence of either vaginitis or vaginosis. Finally, 73 pregnant women were investigated. The LE activity in vaginal fluid during different weeks in the cycle of 53 of the women was measured. Results: In the non-pregnant women, an increased LE activity was found in 96, 88, 73 and 56% of those with RVVC, VVC and BV and in the non-VVC/BV cases, respectively. In 73% of pregnant women in the second trimester, and 76% of those in the third, the LE test was positive. In all groups of non-pregnant women tested, the LE activity correlated with the number of leukocytes in vaginal smears, but it did not in those who were pregnant. There was no correlation between LE activity and week in cycle. The vaginal pH showed no correlation to LE activity in any of the groups studied. Conclusions: The use of commercial LE dipsticks has a limited value in the differential diagnosis of RVVC, VVCand BV. There is no correlation between the LE activity in vaginal secretion on one hand and vaginal pH, week in the menstrual cycle and trimester in pregnancy on the other. Women with BV often have signs of inflammation as evidenced by a positive LE test and inflammatory cells in genital smears.

Novikova, Natalia; Niklasson, Ola; Bekassy, Zoltan; Skude, Lennart

2003-01-01

451

Pharyngocutaneous fistula following total laryngectomy: multivariate analysis of risk factors.  

PubMed

The objective of this study is to establish the role of risk factors in the etiology of pharyngocutaneous fistula formation after total laryngectomy. A retrospective study was performed for patient, disease and treatment-related factors, and also factors related to pathology specimen. Logistic regression analysis revealed that fistula development ratio was 4.955 times higher in patients with fistula than in the control group when the preoperative hemoglobin value was below 12.2 g/dL, 3.653 times higher when the postoperative hemoglobin value was below 12.2 g/dL, 3.471 times higher in the presence of an accompanying systemic disease, 3.23 times higher when the postoperative albumin level was below 3.5 g/dL, 3.1 times higher when ipsilateral lymph node was positive, 2.05 times higher when erythrocyte suspension is used as transfusion material, and 1.048 times higher when contralateral lymph node was positive. Proper concomitant systemic disease control, maintenance of hematologic values in the pre- and postoperative periods, provision of adequate nutrition, preference of erythrocyte suspensions for transfusion are the key points for the prevention of pharyngocutaneous fistula development. Preoperative detection of positive cervical lymph nodes should alert the physician about the potential development of fistula. PMID:22806057

Erdag, Mehmet Ali; Arslanoglu, Secil; Onal, Kazim; Songu, Murat; Tuylu, Abdurrahman Onur

2012-07-18

452

Cholecystogastric fistula presenting with haematemesis: diagnosed by endoscopic retrograde cholangiography.  

PubMed

The case is reported of a 72-year-old woman suffering from morbid obesity, who presented with haematemesis while on anti-coagulant therapy. The source of the bleeding proved to be the gastric exit of a cholecystogastric fistula. Subsequent cholangitis was successfully treated by endoscopic retrograde cholangiography (ERC) and endoscopic sphincterotomy (ES) while simultaneously the extent of the fistula was established. Cholecystectomy and closure of the fistula was contraindicated because of her morbid obesity. She remained well for 6 months but then presented with a gallstone ileus while another stone was found to be escaping from the gastric fistula. Her morbid obesity resulted in surgical procrastination, which eventually proved fatal. This patient experienced both of the most common types of complication in cholecysto-enteral fistulation, cholangitis and gallstone ileus. Although cholecysto-enteral fistulas (CEF) are probably less common than several decades ago, they are now most likely to be diagnosed during ERC. Gastroenterologists therefore need to be aware of their potential to contribute to the diagnosis and treatment of this surgical condition. PMID:11111783

Verhage, A H; van Blankenstein, M; Beukers, R; van Vliet, A C

2000-11-01

453

Selective bilateral bronchial intubation for large, acquired tracheoesophageal fistula.  

PubMed

The anesthetic management of patients undergoing tracheoesophageal fistula repair often involves lung separation, usually selective bronchial intubation with a double-lumen endotracheal tube. However, in patients with airway fistulas arising below the tracheal lumen, selective lung ventilation and separation may require unusual methods of airway management. In the patient described in this report, the airway fistulas involved the distal 3 cm of the trachea, approximately half of the left main bronchus 1.5 cm beyond the carina, and the proximal 0.5 cm of the right main bronchus. To separate and ventilate the lungs during the repair of these large and complex airway fistulas, 2 individual Mallinckrodt microlaryngeal endotracheal tubes were used. While lung separation was achieved, contrary to previous reports, the Mallinckrodt's larger and more tapered cuff made positioning in the left main bronchus an ongoing issue that required the use of a conventional endotracheal tube and, eventually, intubation of the bronchus from the surgical field. Future cases involving complex airway fistulas should consider endotracheal tube limitations and other methods of providing ventilation such as high-frequency jet ventilation or cardiopulmonary bypass. PMID:22474805

Ford, Jeffrey M; Shields, John A

2012-02-01

454

Interventional embolization therapy of puerile congenital deep femoral arteriovenous fistula  

PubMed Central

This study aimed to investigate the treatment efficiency of interventional embolization therapy in puerile congenital deep femoral arteriovenous fistula. A retrospective analysis was conducted for 9 cases of congenital deep femoral arteriovenous fistulae treated in our department in the past 5 years. B-ultrasound examination indicated that all puerile patients suffered from deep femoral arteriovenous fistulae, which was confirmed by angiography examination. For all patients, endovascular interventional embolization therapy was conducted and angiography re-examination was implemented after 4 weeks. If there were residual orificium fistulae, the interventional embolization therapy was conducted again. In the 6 month to 2 year follow-up period, improvement of clinical symptoms was observed. Following interventional embolization, 9 cases of deep femoral arteriovenous fistulae were completely occluded and the clinical symptoms were improved. No relapses occurred. In addition, after three embolization treatments, the disease condition of one case was controlled well and the disease condition did not progress. Interventional embolization therapy has a number of advantages, including simple surgery and reliable treatment efficacy. Therefore, it is worthy of promotion and application in the clinic.

ZHANG, JING; TAN, XIAO-YUN; ZHOU, SHAO-YI; CHEN, KUN-SHAN; LI, HAI-BO; CHUANQIANG-NIU; JIANG, YI-ZHOU; LIN, QUE-QING

2013-01-01

455

Spontaneous skull base meningoencephaloceles and cerebrospinal fluid fistulas.  

PubMed

Cerebrospinal fluid (CSF) fistulas are characterized by the egress of CSF from the intracranial cavity through an osteodural disruption between the subarachnoid space and a pneumatized structure within the skull base. Depending on the cause, CSF fistulas are classified as acquired or congenital, and acquired fistulas are further classified as traumatic, nontraumatic, or spontaneous. Spontaneous CSF fistulas are considered to result from a multifactorial process and have been postulated to represent a variant of idiopathic intracranial hypertension. However, an anatomic predisposition involving thinning of the cranial base, such as pneumatization of the sinus walls, must also be present. This process creates areas of structural weakness that act as potential pathways for CSF leaks, which most commonly occur in the ethmoid roof, sphenoid sinus, and temporal bone. Because CSF leaks may be overlooked, a result of their asymptomatic or subtle, intermittent course, a high level of suspicion is crucial in making an early diagnosis. However, CSF fistulas may be well seen at computed tomography (CT), which depicts bone defects, and magnetic resonance cisternography, which reveals the contents of herniated tissue. Knowledge of the location and size of the bone defect and herniated contents is crucial for the selection of surgical approach and grafting material. PMID:23479713

Alonso, Raquel Cano; de la Peña, Mar Jimenez; Caicoya, Anne Gomez; Rodriguez, Manuel Recio; Moreno, Elena Alvarez; de Vega Fernandez, Vicente Martinez

456

Seton management of complex anorectal fistulas in patients with Crohn's disease  

Microsoft Academic Search

Anorectal fistulas associated with Crohn's disease are difficult to manage, particularly when the rectum is diseased. Significant morbidity has been associated with both medical and surgical therapy. Although conventional therapy is acceptable in the management of simple fistulas in Crohn's disease, these approaches often exacerbate rather than ameliorate problems in patients with complex fistulas. The authors report ten cases of

Ronald A. White; Theodore E. Eisenstat; Robert J. Rubin; Eugene P. Salvati

1990-01-01

457

Spinal dural arteriovenous fistulas: a congestive myelopathy that initially mimics a peripheral nerve disorder  

Microsoft Academic Search

Spinal dural arteriovenous fistula (SDAVF) is a rare and enigmatic disease entity. The clinical features and structural changes have been recognized since 1926, and the pathophysiology and the essentials of treatment since 1974, but up to the present day it is unknown why these fistulas develop. The fistula between a radicular artery and the corresponding radicular vein within the dural

K. Jellema; C. C. Tijssen; J. van Gijn

2006-01-01

458

Three Cases of Dural Arteriovenous Fistula of the Anterior Condylar Vein within the Hypoglossal Canal  

Microsoft Academic Search

Summary: Dural arteriovenous fistulas (DAVFs) of the an- terior condylar vein are an uncommon but important sub- set of fistulas occurring at the skull base that can be con- fused with DAVFs of the marginal sinus on angiography. MR angiography source images can document the intraos- seous extent and the relationship to the hypoglossal canal of this type of fistula,

Robert Ernst; Robert Bulas; Thomas Tomsick; Harry van Loveren; Khaled Abdel Aziz

1999-01-01

459

Fibrin Glue-Antibiotic Mixture in the Treatment of Anal Fistulae: Experience with 69 Cases  

Microsoft Academic Search

Background\\/Aims: To investigate the potential value of the use of the fibrin glue-antibiotic mixture in the treatment of anal fistulae. Materials and Methods: This study included 69 patients with idiopathic nonspecific anal fistulae. Patients with IBD (inflammatory bowel disease), TBC, actinomycosis, and cancer were excluded from the study. The microbiological analysis of the discharge of the fistula was done routinely.

Leonardo Patrlj; Branislav Kocman; Miran Martinac; Tomislav Šoša

2000-01-01

460

Transposed brachial-basilic arteriovenous fistulas versus prosthetic upper limb grafts: A meta-analysis  

Microsoft Academic Search

BackgroundControversy exists regarding the best type of arteriovenous (AV) fistula to be formed in secondary and tertiary access procedures when primary fistulas have failed. This meta-analysis aimed to compare transposed brachial-basilic AV fistulas (BBAVFs) with upper limb AV prosthetic grafts.

M. K. Lazarides; G. S. Georgiadis; C. P. Papasideris; G. Trellopoulos; V. D. Tzilalis

2008-01-01