Questions posted in the
The Urology Forum have been answered by urologists from Henry Ford Health System and by Dr. Kevin Pho.
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Subject: Re: fistula Topic Area: IncontinencePosted by Emily on July 19, 1999 at 01:13:32Dear Doctor,
Posted by HFHS M.D.-JS on July 22, 1999 at 12:03:57
= Dear Shelly, Thank you for your inquiry. Women with stress urinary incontinence often are treated surgically with a pubovaginal sling. The sling has been used with good success. Different materials have been implanted to create a sling some being autologous tissue and some artificial. The most recent materiel being the protogen sling. The artificial slings have been shown to have a higher rate of erosion through. the anterior vaginal wall. The presenting sign being discharge from the vagina. The sling is explanted once it has eroded. One of the main complication from slings is urinary retention and opposite side of the spectrum continued stress incontinence. The continued bleeding you have experienced is difficult to comment upon but it sound like the sling eroded through the vagina causing some bleeding and urinary incontinence. The fistula you have refer to can be a difficult complication to treat. The cause of a fistula tract include foreign body i.e.sling, cancer, obstruction, infection. It is important to allow the fistulous tract to heal with catheter drainage and it may take several weeks to months.. If you continue to have leakage soon after the procedure it will not likely improve. The majority of urologist are waiting for about six months before trying a second sling/bladder neck suspension. Autologous rectus fascia appears to have lower erosion rates. Sincerely,
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