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A 46-year-old patient who had underwent a hysterectomy developed a fistula, a complication that may occur following this procedure. In this case, a vesicovaginal fistula, which is an abnormal opening between the bladder and the wall of the vagina, had formed. This resulted in continuous and unremitting urinary incontinence through the vagina, which forced the patient to continuously use sanitary pads for 5 months.
Diagnosed by Dr. Fahad Algreisi, Consultant of Obstetrics and Gynecology, Women's Urology and Endoscopy, doctors concluded that the patient needed a precise endoscopic procedure to close the fistula. During the follow-up, it was confirmed that there was no inflammation in the bladder so that this would not affect the success of the procedure. The necessary imaging were also performed to determine the location and size of the fistula with the help of the radiology team led by Dr. Nouf Abdullah, Chairman, Medical Imaging Department, Consultant Diagnostic Radiologist and Women's Radiologist at the International Medical Center.
The medical team faced many challenges while studying the case and discussing the treatment plan, including the presence of abdominal adhesions due to the previous procedure, which meant that the laparoscopy was not suitable for this procedure. In addition, the length of the fistula tracts measured around 1 cm, in addition to the fistula's proximity to ureters, which requires taking precautions so that no injury occurs to the ureters during the procedure.
In order to overcome these challenges, the medical team used the cystoscope as the safest and most accurate technique to locate the fistula, and to place ureteral catheters to ensure their safety during the procedure, then the closure of fistula was carried out through abdominal incision. The procedure was thankfully successful, and the patient soon returned to her home were satisfied with her condition.
The medical team that performed the procedure consisted of Dr. Fahad Al Greisi, Consultant of Obstetrics and Gynecology, Urogynecology and Endoscopy; Dr. Feras Allagany OB/GYN & Urogynecology Consultant ; Dr. Hiba Abourafia, Senior Registrar, Obstetrics and Gynecology; Dr. Laila Al-Nashri, resident doctor; as well as the anesthesiology and nursing teams.
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