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81	2 UNDERSTANDING THE CAUSE AND NATURE OF VESICO-VAGINAL FISTULAE Vesico-vaginal ﬁstulae are caused simply by unrelieved obstructed labour. Prolonged pressure of the baby’s head against the back of the pubic bone produ Add to Reading List Source URL: www.glowm.com Language: English - Date: 2009-09-11 05:31:16 Female reproductive system Urinary system Pelvis Gynecological surgery Gender transitioning Vesicovaginal fistula Vagina Childbirth Urethra Medicine Anatomy Human reproduction
82	12 POSTOPERATIVE CARE OF THE FISTULA PATIENT A good operation can be ruined by neglectful aftercare. It is the surgeon’s responsibility to ensure that the nurses and carers know what is required. In reality, nurses wil Add to Reading List Source URL: www.glowm.com Language: English - Date: 2009-09-11 05:32:35 Urinary retention Obstetric fistula Stress incontinence Vesicovaginal fistula Urethra Urinary catheterization Foley catheter Medicine Incontinence Catheters
83	01-text-POFS-cpp:master[removed]:44 Add to Reading List Source URL: www.glowm.com Language: English - Date: 2009-09-11 08:37:34 Pregnancy Gynecological surgery Fistula Gender transitioning Rectovaginal fistula Obstetric fistula Childbirth Urethra Vesicovaginal fistula Medicine Anatomy Urinary system
84	01-text-POFS-cpp:master[removed]:46 Add to Reading List Source URL: www.glowm.com Language: English - Date: 2009-09-11 08:37:59 Vesicovaginal fistula Caesarean section Vagina Childbirth Urethra Fistula Medicine Human reproduction Reproduction
85	9 PROBLEMS AND DIFFICULTIES Difﬁcult access If access is difﬁcult, the surgeon should not hesitate to perform an episiotomy, bilateral if necessary (Figure 34). These are easy to suture. Add to Reading List Source URL: www.glowm.com Language: English - Date: 2009-09-11 05:32:50 Urethra Urination Urethral stricture Urinary retention Medicine Bladder stone Catheter
86	8 A SIMPLE FISTULA REPAIR, STEP BY STEP The ﬁrst step is to suture the labia to the thighs and cover the anus with a swab (Figure 31). Figure 31 The labia are sutured to the thighs and the anus is covered with a Add to Reading List Source URL: www.glowm.com Language: English - Date: 2009-09-11 05:30:24 Female reproductive system Vesicovaginal fistula Vagina Obstetric fistula Urethra Fistula Foley catheter Urinary bladder Bladder stone Medicine Anatomy Urinary system
87	6 THE OPERATIONS BASIC PRINCIPLES Basic principles are described here; strategies for speciﬁc situations are discussed in later sections. The basic principles in the repair of a ﬁstula are: Add to Reading List Source URL: www.glowm.com Language: English - Date: 2009-09-22 05:38:33 Stress incontinence Urethra Obstetric fistula Vagina Foley catheter Fistula Urinary retention Bladder stone Urination Medicine Urinary system Incontinence
88	PRACTICAL OBSTETRIC FISTULA SURGERY THE ABDOMINAL APPROACH When is an abdominal repair appropriate? Several full-time ﬁstula surgeons, including Andrew Browning, claim that they can repair all ﬁstulae by the vaginal Add to Reading List Source URL: www.glowm.com Language: English - Date: 2009-09-22 05:42:28 Urinary system Female reproductive system Gender transitioning Male reproductive system Urethra Vulva Foley catheter Urinary bladder Vagina Medicine Anatomy Biology
89	PRACTICAL OBSTETRIC FISTULA SURGERY (a) (b) Add to Reading List Source URL: www.glowm.com Language: English - Date: 2009-09-22 05:42:01 Urology Male reproductive system Urethra Stress incontinence Urinary bladder Urinary retention Urethral stricture Anatomy Urinary system Medicine
90	00-prelims-POFS-cpp:master[removed]:59 Add to Reading List Source URL: www.glowm.com Language: English - Date: 2009-09-11 08:46:14 Urethra Sphincter Biology Medicine Anatomy Incontinence Stress incontinence

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