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. When you have a fistula, urine exits your body through your vagina, and you cannot control the flow of urine.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

You may bleed more than expected or get an infection. Your ureters may be damaged. You may have bladder spasms and vaginal bleeding. You may develop bladder stones or not be able to empty your bladder completely. You may still leak urine or have urges to urinate often. Surgery also may make your bladder smaller or shorten your vaginal canal. Even after having surgery to remove your fistula, a new fistula may form.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • You may be given antibiotics to help prevent a bacterial infection.

  • Anesthesia is medicine to make you comfortable during the surgery. Healthcare providers will work with you to decide which anesthesia is best for you.

    • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

    • Spinal or epidural anesthesia numbs the area and dulls the pain. You may still feel pressure or pushing during surgery.

During your surgery:

  • Your surgeon will insert a scope through your urethra to check the location of your fistula. He will place a stent in each ureter to protect them during surgery. He will make an incision around the fistula. Your surgeon will cut out and remove the fistula, or sew it closed. He will separate the outside walls of your vagina and bladder. Your surgeon will close the incision with stitches. He may put bandages soaked with antibiotic medicine in your vagina to help prevent infection.

  • If your surgery is done through your abdomen, your surgeon will make an incision under your belly button. He will cut the wall of your bladder away from your vagina and remove the fistula. He may put a suprapubic catheter through your abdomen and into your bladder before it is closed. The catheter is used to drain your urine and may stay in place for up to 3 weeks. You may also need a drain to remove extra blood and fluid. Your surgeon will close the incision with stitches.

After your surgery:

You will be taken to a room to rest until you are fully awake. You will be monitored closely for any problems. Do not get out of bed until your healthcare provider says it is okay. You will then be able to go home or be taken to your hospital room.

  • You will be able to eat and drink gradually after surgery. You will begin with ice chips or clear liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then eat soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

  • A Foley catheter is a tube put into your bladder to drain urine into a bag. Keep the bag below your waist. This will prevent urine from flowing back into your bladder and causing an infection or other problems. Also, keep the tube free of kinks so the urine will drain properly. Do not pull on the catheter. This can cause pain and bleeding, and may cause the catheter to come out. Caregivers will remove the catheter as soon as possible to help prevent infection.

  • Medicines:

    • Pain medicine may be given. Do not wait until the pain is severe before you ask for more medicine.

    • Anticholinergic medicine may help relax your bladder and prevent bladder spasms.

    • Antibiotics help prevent a bacterial infection.

© 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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