The Use of Fibrin Sealant in the Treatment of Urinary Bladder Fistulae

Frea, Bruno; Cocimano, V.; Mosele, Giulia Raffaella; Plana, P.; Biancardi, L.; Annoscia, S.; Lozzi, C.

doi:10.1007/978-3-642-71453-5_22

Cited by 3 publications

(2 citation statements)

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“…The selection of cases for treatment with fibrin sealant is very important in the opinion of some workers [5], who opine that the fistula must be recent,the edges of the fistulous opening must be scrapped before application of fibrin sealant and fibrin must be injected under the mucosa to plug the fistulous opening. Early results are encouraging and the use of this technique may produce revolutionary results that will modify the approach to fistula management.…”

Section: Case Reportmentioning

confidence: 99%

Vesicovaginal Fistula : A New Treatment Modality

Kapur

Rana

2007

Medical Journal Armed Forces India

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umbilical and one supra pubic scar marks. Liver and spleen were not palpable. Per speculum examination revealed that the vagina and vault were wet with urine. A 0.5 x 0.5 cm fistula was visualized at the vault in the center. On per vaginal examination the vault was supple with no palpable mass. On investigation, complete haemogram, urine routine examination, serum electrolytes, renal function tests, ultrasound (abdomen and pelvis) were within normal limits. A three-swab test done confirmed the fistula to be vesicovaginal. Intravenous pyelogram (IVP) showed normally functioning kidney with normal ureteric outline.The patient was taken up for cystoscopy, which revealed a scarred area on the posterior wall of the bladder above the trigone with a fistulous opening. A probe was passed through the fistulous opening in the vagina and the fistulous opening in the bladder was localized by cystoscopy being done at the same time. In view of the prolonged history of the patient, multiple surgeries and small size of the fistula, a decision was taken to attempt sealing of the fistula with fibrin sealant .Under cystoscopic guidance and local anaesthesia, a probe was passed through the fistulous opening in the vagina and margins of the fistula traumatized, in an attempt to freshen the margins. The cystoscope was removed and 2ml of reconstituted fibrin glue (Tissucol) was injected into the fistulous opening in the vagina using a Duploject syringe. The patient was then put on a continuous Foley's catheter for seven days. The patient had no leakage of urine in the postoperative period. The patient had no incontinence of urine after catheter removal and she was voiding satisfactorily. The patient was followed up at three months, when she was found to be asymptomatic and extremely satisfied with the procedure.

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Section: Case Reportmentioning

confidence: 99%

Vesicovaginal Fistula : A New Treatment Modality

Kapur

Rana

2007

Medical Journal Armed Forces India

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“…Fibrin glue has many uses in urology (Vecsey, 1986), not only for its haemostatic properties but also as a sealant in ureteric surgery (Schultz and Christiansen, 1985), in reconstructive urethral surgery (Spehr, 1986) and the repair of urinary bladder fistulae both endoscopically (Frea et al, 1986) and transperitoneally . It is made by combining a solution of fibrinogen concentrate and factor XI11 with a solution of thrombin and calcium.…”

Section: Open Surgerymentioning

confidence: 99%