Vesico-vaginal fistula presenting as overactive bladder in a case of Gellhorn pessary for vault prolapse
| Autor: | Santanu Acharya, Mamta Bhat, Wael Agur |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pessary
medicine.medical_specialty Fistula 030232 urology & nephrology Case Report Incontinence pads Vesicovaginal fistula Pelvic Organ Prolapse 03 medical and health sciences 0302 clinical medicine Vesico-Vaginal Fistula Medicine Humans General anaesthesia Aged 80 and over 030219 obstetrics & reproductive medicine Vesicovaginal Fistula business.industry Urinary Bladder Overactive General Medicine Pessaries medicine.disease Surgery Overactive bladder Female Presentation (obstetrics) business |
| Zdroj: | BMJ Case Rep |
| Popis: | An 81-year-old woman with early dementia was on a regular follow-up for change of Gellhorn pessary every 6 months for vault prolapse. She presented with frequency and urgency for 10 months duration 5 years into conservative management. Her symptoms did not improve on anticholinergics and lifestyle modifications. She underwent an opportunistic change of pessary under general anaesthesia coincidental to scalp wound debridement. On removal of the pessary, a gush of urine was noted followed by confirmation of a large vesico-vaginal fistula (VVF). In the initial period of follow-up, she was reviewed by the urogynaecology team and considered to be a poor surgical candidate for a major surgical procedure and was offered conservative measures with incontinence pads and possible indwelling catheter. Serious complications like fistulae can still occur despite well-managed pessary treatment. Earlier presentation with overactive bladder symptoms masked the VVF resulting in delayed diagnosis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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