BEST MANAGEMENT OF GYNECOLOGICAL AND OBSTETRIC URINARY FISTULAS IN DELHI NCR (VVF UVF)
Dr Vijayant G Gupta is a Consultant Urologist in Delhi NCR specialising in Urogynecology in delhi NCR. I have special interest in the management of Gynecological urinary fistulas like Vesicovaginal fistula (VVF) and Ureterovaginal fistula (UVF) and others in Delhi NCR and Gurgaon. For an appointment you can contact me on email or message.
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WHAT IS VVF?
Urinary fistulas arising in a women is a complex and multi faceted problem. Apart from a cause of grave concern and psychosocial issues in the women herself, it can cause tension and emotional distress to the family, including the newborn if it is a case after child birth.
Urinary fistulas present as continuous urinary leakage in women. This chronic incessant leakage causes wetting, bad smell, skin soiling infections and may lead to the woman becoming a social outcast, either by choice or by societal pressure. Female urinary fistulas is a pertinent cause of incontinence or urinary leakage in women. Most women decline treatment because of embarrassment or shame.
But, female urinary fistulas are eminently treatable and their management though difficult and controversial, once successful, provide long lasting relief to patients and their families.
There are many types of female gynecological urinary fistulas, most common of which is the Vesico vaginal fistula or the VVF. But the other varieties are –
- VESICO VAGINAL FISTULA – VVF
- URETEROVAGINAL FISTULA – UVF
- UTERO VAGINAL FISTULA – UtVF (YOUSSEF SYNDROME – CYCLICAL HEMATURIA AND MENOURIA)
WHAT ARE THE CAUSES OF FEMALE URINARY FISTULAS?
There are many causes of female urinary fistulas like VVF. In the order of common to least common they are –
- Iatrogenic (60%) – In the age of Hysterectomy or Uterus removal due to many causes, an unintended sequelae is formation of a supratrigonal VVF or Vesicovaginal fistula. This is the number one cause of medicolegal litigation in India today. But understand that, rarely is the surgeon involved guilty as the female pelvic anatomy makes any surgery difficult and inadvertent injuries do happen. Other surgeries that can lead to VVF, UtVF etc are Cesarian Section, Gynecological incontinence tapes or slings, D and C, Abortion etc.
- Obstetric or Child birth (30%) – Obstructed labor or stuck baby, especially in Indian Women can cause large complicated fistulas that are difficult to treat. Occurring mostly in rural areas, but still occasionally seen in urban or Rurban centres.
- Cancer and Radiation (5%) – Women unfortunate to have Cancer of the cervix or Endometrium may develop a urinary fistula
- Radiation (2%) – Women receiving radiation for their cancers, can develop fistulas in th elong term
- Miscll – Some fistulas are never characterised and are an enigma for any treating urologist.
WHO TREATS FEMALE URINARY FISTULAS (VVF MANAGEMENT DELHI NCR GURGAON)
VVF management falls in a zone shared between the specialities of Gynecology and Urology. The fistula will go between the vagina and the bladder and many will require the expertise of both. But, conventionally Urinary fistulas are best managed by a Urologist. (Best Urologist in Delhi).
I have significant experience in managing Urinary Female Fistulas like VVF. I am experienced with vaginal, abdominal approach and the robotic approach to managing VVF. Take an appointment today for Scientific Ethical Economical and Moral treatment of VVF in Delhi NCR and Gurgaon.
Kindly understand that VVF management is difficult and requires time and patience. Kindly do not expect magic.