Surgical Repair Considerations

Each VVF case should be individualized. The first attempt is associated with the highest success rate. In cases in which the VVF is the result of complicated obstetric trauma, fistula repair can be delayed 3 to 6 months to allow inflammation to be resolved. If the VVF is secondary to uncomplicated hysterectomy, or a clean surgical wound is present, early repair (6-8 weeks) is indicated. The surgical approach for repair depends on surgeon preference and the location of the fistula. However, the TV approach is less morbid than the TA and is the most frequently used for repair. Transabdominal approach is indicated for reimplantation, augmentation, and if the vagina is narrow or the fistula is high. Transvaginal approach can be used for VVF repair when entering the peritoneal cavity is to be avoided.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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