After undergoing a partial cystectomy for carcinoma of the rectum, a 76-year-old woman develops a vesicovaginal fistula. The repair will have a higher chance of success if which of the following occurs?
Repair of vesicovaginal fistula is recommended after enough time has passed, to allow a reduction in the inflammatory reaction and even spontaneous closure to occur. To promote spontaneous closure, a Foley catheter is inserted for bladder drainage. It is advised to perform meticulous repair, excision of previous fistulous tract, and tension-free anastomosis. Frequently an omental interposition helps to separate overlapping suture lines.
Scare tissue is not excised
The bladder wall is closed under tension
Repair is performed more than 6 months after the causative operation
Repair is performed within 7-14 days of the onset of symptoms
Urethra & Penis