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Related Experiment Videos

Urologic surgical techniques.

B L Shull1

  • 1Scott & White Clinic, Texas A&M University College of Medicine, Temple 76508.

Current Opinion in Obstetrics & Gynecology
|August 1, 1991
PubMed
Summary
This summary is machine-generated.

Gynecologists should suspect fistulae and diverticula in patients with incontinence. Surgical repair, like the obturation shelf repair, can effectively treat postoperative voiding dysfunction in about 90% of cases.

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Area of Science:

  • Gynecology
  • Urology

Background:

  • Surgery for incontinence, excluding genuine stress incontinence, is infrequent in general gynecology.
  • High suspicion for diverticula and fistulae is crucial for diagnosis.
  • Iatrogenic incontinence presents a significant challenge for patients and clinicians.

Purpose of the Study:

  • To review current management strategies for complex incontinence and genitourinary fistulae.
  • To highlight effective surgical techniques for postoperative voiding dysfunction.
  • To discuss practical approaches to postoperative bladder care.

Main Methods:

  • Review of existing literature and classic references on incontinence and fistulae.
  • Description of management options for cancer-related genitourinary fistulae, including percutaneous nephrostomy and continent diversion (e.g., Indiana pouch).

Related Experiment Videos

  • Detailed explanation of the obturation shelf repair for postoperative obstructive voiding dysfunction.

    • Main Results:

    • The obturation shelf repair, similar to paravaginal defect repair, restores normal anatomy and achieves excellent relief of voiding dysfunction in approximately 90% of patients.
    • Continent diversion offers a long-term solution for selected patients, even those previously irradiated.
    • Innovative and practical approaches to postoperative catheter removal timing are presented.

    Conclusions:

    • Complex incontinence and genitourinary fistulae require a high index of suspicion and specialized management.
    • The obturation shelf repair is a highly effective surgical option for iatrogenic voiding dysfunction.
    • Optimizing postoperative bladder care, including catheter management, is essential for patient recovery.