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Vesicovaginal Fistula Repair

WHAT YOU SHOULD KNOW:

  • Vesicovaginal fistula repair is surgery to close or remove a fistula between your bladder and vagina. A fistula is an abnormal tissue connection or hole. Your bladder is an organ at the bottom of your abdomen (stomach) where urine is stored. Your vagina is the opening through which you have your monthly period and give birth. Urine normally flows from your kidneys into your bladder through your ureters. From your bladder, urine flows out of your body through your urethra. When you have a vesicovaginal fistula, urine will exit your body through your vagina. When this occurs, you will not be able to control the flow of your urine.

  • Vesicovaginal fistulas may happen after having surgery to remove your uterus (womb). Fistulas also may occur after having surgery on your urethra. Radiation to treat cancer of the cervix (the opening of the uterus) also may cause a fistula. During surgery, your caregiver closes or removes the fistula to prevent urine from leaking. Surgery may be done through your vagina, or through incisions (cuts) in your abdomen. Having your vesicovaginal fistula repaired may decrease your risk for skin infections and irritation from leaking urine. Surgery may decrease, or completely stop the leakage of urine through your vagina.

INSTRUCTIONS:

Medicines:

  • Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.

  • Take your medicine as directed: Call your healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.

  • Pain medicine: You may need medicine to take away or decrease pain.

    • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.

    • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

  • Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your healthcare provider. Do not stop taking your medicine unless directed by your healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.

  • Anticholinergic medicine: This medicine is given to help relax your bladder and prevent bladder spasms.

Follow-up visit:

  • Ask your caregiver when to return for a follow-up visit. You may need a follow-up visit to remove the stitches from your surgery. Before your urinary catheter is removed you may need a cystogram, ultrasound, or an intravenous pyelogram. These tests are done to look at your bladder and check if it has healed. The tests are also done to check if you are still leaking urine into your vagina. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Caring for your catheter:

You may have a Foley or a suprapubic catheter in place after leaving the hospital to constantly drain your urine. Always keep the bag of drained urine well below your waist. Lifting the urine bag higher will make the urine flow back into your bladder, which can cause an infection. Avoid pulling on the catheter because this may cause pain and bleeding, and the catheter may come out. Do not allow the catheter tubing to kink because this will block the flow of urine. Ask your caregiver how to clean around your catheter properly to prevent infection.

Drink enough liquid:

Women 19 years old and older should drink about 2.2 Liters of liquid each day (close to 9 eight-ounce cups). Good choices for most people to drink include water, juice, and milk. Drinking liquids will help flush blood from surgery out of your bladder through your urine. Ask your caregiver how much liquid you should drink each day.

Having sex:

You will need to avoid sexual intercourse (sex) for 3 to 4 months after your surgery. Not having sex allows the tissues in your vagina to heal. Ask your caregiver when you can have sex again.

Using tampons:

Do not use tampons for at least three months after your surgery. Inserting items into your vagina can damage the tissues and prolong your healing.

CONTACT A CAREGIVER IF:

  • You have a fever.

  • You have a burning feeling or pain when you urinate.

  • You are leaking urine through your vagina.

  • You have questions or concerns about your surgery, medicine, or care.

SEEK CARE IMMEDIATELY IF:

  • Your abdominal wound is bleeding and will not stop.

  • You are bleeding from your vagina, and it is not time for your monthly period.

  • You have yellow or foul smelling discharge from your vagina or abdominal wound.

  • You have a urine catheter and no urine is draining into the bag.

  • Your urine catheter has been removed and you cannot urinate.

  • Your wound is swollen, red, or has pus coming from it.

  • You have sudden trouble breathing.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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