Lecture notes for medical students

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2. Introduction

3. Introduction
Urinary fistulae

4. Etiology

5. Etiology
• Congenital
• Obstretic trauma >VesicoVaginal
Fistula(VVF)
• Perforating wounds,
• Damage not recognised during surgery
• Avascular necrosis following radiotherapy
• Clot retention occurring after an open
bladder operation
• Malignancy

6. Etiology
• Acute abacterial cystitis (acute
hemorrhagic cystitis)
• Frequency–dysuria syndrome (urethral
syndrome)
• Tuberculous urinary infection
• Interstitial cystitis (Hunner’s ulcer)
• Alkaline encrusting cystitis
• Cystitis cystica
• Schistosomiasis of the Bladder
(Bilharziasis)

7. Foreign body in Urinary Bladder
• fragment of catheter balloon.
• non-absorbable suture

8. Complications

9. Complications
• UTI;
• perforation of the bladder wall;
• bladder stone.

10. Diagnostic Studies

11. Diagnostic Studies
• Abd USG

12. Non Operative Therapy

13. Non Operative Therapy
• Cystoscopy.

14. Operative Therapy

15. Operative Therapy
• Suprapubic Cystostomy.

16. Congenital urinary fistulae

17. Congenital urinary fistulae
• Ectopia vesicae.
• Patent urachus –
• In association with imperforate anus

18. Vesicovaginal fistula
Aetiology

19. Vesicovaginal fistula
Aetiology
• Obstetric. The usual cause is protracted
or neglected labour.
• Gynaecological. operations
total hysterectomy
anterior colporrhaphy.
• • Radiotherapy.
• Malignancy-carcinoma of cervix

20. • SPECIAL FORMS OF LOWER
URINARY TRACT INFECTION

21. Questions
• Full question
• Short Note
• Long case
• Short case
• MCQs

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