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.

Herbal Remedies For Acid Reflux

Herbal Remedies For Acid Reflux

Gastroesophageal reflux disease is the medical term for what we know as acid reflux. Acid reflux occurs when the stomach releases its liquid back into the esophagus, causing inflammation and damage to the esophageal lining. The regurgitated acid most often consists of a few compoundsbr acid, bile, and pepsin.

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