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My Wife Undergone Major Surgery On 20-09-2019 In Apollo Hospital

Posted on Sun, 10 Nov 2019

Question: My wife undergone major surgery on 20-09-2019 in Apollo hospital XXXXXXX type 1 radical hysterectomy with bilateral pelvic nodal dissection, after 7 days of Surgery urine leakage was started unknowingly ( urine unconscious), to deduct the issue CT Scan contrast was done on 17-10-2019 (after removal of stiches), found there is surgical urine bladder damage ( 8 mm hole ),
and advised to see urology doctor urology doctor priscribed soliten bladder over active controll tablets for 45days saying that it will cure naturally , i am bit worry is it cure naturally? and cather also removed they are saying it will create infection, but when i googled cather must be placed to cure naturally,
i need second opinion.

Answered by Dr. Dr. P. T. Patil (4 hours later)

Brief Answer:
Ideally catheter has to be be placed to have continuous bladder drainage

Detailed Answer:
Hello
Thanks for query .

Based on the facts and reports that you have posted your wife who has undergone surgery of Radical Hysterectomy last month has developed Vesico Vaginal Fistula (5 X8 mm) leading to continuous leakage of urine through vagina .This is abnormal communication that develops due to inadequate blood supply after surgery and is known to happen in 5% of patients after Radical Hysterectomy .

In few cases one can expect this fistula to get healed up and closed spontaneously over a period of 4-6 weeks but it is normal protocol to keep the catheter to have continuous drainage of bladder so as to keep fistula tract dry to help it to heal up .

However it does happen that in some cases the fistula does not get closed and in such a situation one has to undergo surgery of excision of fistula tract and re repair the vagina and bladder.

Hope I have answered your query ,please feel free to ask if you have more questions,I shall be happy to help you
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. P. T. Patil (2 hours later)

Sir my question is Apollo urology doctor not advised to keep Cathter , then how it will heal naturally , he is saying it will infect the bladder , he advised to go frequently urinate and night time keep adult diaper,

please advise Sir shall we keep Cather now for two weeks , it is already one month after surgery.

one Question just one month before she had a Radical surgery , it is recommended surgery again , Any limit gap is required in between Surgery ( Days).

Please Advise Sir silicon catheter we can place now with any antibiotics.

Answered by Dr. Dr. P. T. Patil (55 minutes later)

Brief Answer:
I can not comment on advice of Urologist from Apolo Hospital.

Detailed Answer:
hello
Thanks for follow up .
I can not comment on why Urologist from Apolo Hospital advice not to keep catheter .I have opined what is being practiced by majority of Urologist .

It is always better to undergo surgery of repair if fistula does not close spontaneously within 2-3 months .

Thanks and Regards
Dr Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar