Transabdominal Approach

The abdominal approach is recommended for complex VVFs associated with other pelvic organs such as uterus or bowel, those associated with malignancies, or as a result of radiation therapy. The vesicovaginal component of the fistula may be reached by a sagittal cystostomy to provide access to the site of fistula. The fistulous tract is excised and the vesicovaginal space is widely dissected. The opening into the vagina is closed in two layers and the other opening in the bladder is closed in three layers with delayed absorbable sutures. It is recommended that the omentum or peritoneum be placed to separate the vaginal and bladder repairs.

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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