How long can vesicorectal fistula live at most?
summary
Rectourethral fistula is often difficult to repair due to trauma, infection and multiple operations, and the recurrence rate is high. The key to successful repair is to have good exposure to dissect the fistula quickly and safely; Secondly, the old scar and inflammatory tissue around the fistula should be fully removed, and the rectal fistula should be trimmed into the wound edge with blood supply; Third, the tissue with blood supply should be embedded between rectum and urethra to prevent recurrence of fistula. So how long can vesicorectal fistula live at most.
How long can vesicorectal fistula live at most?
First: rectum bladder fistula operation how much money according to the condition to decide, because of external factors caused by urethral injury, urethral atresia, it is easy to form rectum urethral flaccidity. After the urethra and rectum are connected, due to the contamination of feces, urinary tract and pelvic infection are very easy to occur, resulting in serious toxemia. If it is not handled properly, it may cause rectourethral flaccidity, or death due to toxic shock. The shortest time of rectourethral fistula was 3 months, the longest was 26 months, with an average of 11 months.
Second, there are few cases of rectourethral fistula with urethral stricture. The only way is to repair the fistula at the same time with urethral stricture resection and urethrostomy. Its disadvantage is that it is difficult to perform end-to-end anastomosis when the urethral defect is long. Urinary leakage and fistula recurrence often occur due to high tension and poor blood supply at the broken end of urethra, which can lead to penile shortening and curvature. In this operation, perineal scrotal island skin tube was used to replace the defect urethra to repair rectourethral fistula.
Third: if the lesion is located in the rectum and sigmoid colon, proximal enterostomy can be performed first. After the inflammation disappears, the lesion can be resected and the fistula can be closed, and then the colostomy can be closed. Some scholars suggest that all operations should be completed in one stage, and partial intestinal or appendectomy should be performed for small intestinal or appendiceal bladder fistula to close the bladder fistula.
matters needing attention
1. Help the patient adapt to the change of living habits as soon as possible, explain the performance of fistulas and urine bags, the use method, the possible consequences of improper nursing, etc. when the patient changes body position, pay attention to the position of urine bags, to prevent urine reflux, resulting in urinary tract infection. 2. Keep the room clean, reduce the chance of pollution, guide the patients to open the window regularly every day for ventilation, and keep the clothes and bedding clean. 3. In order to prevent the deposition of urine alkali and obstruction of fistulas, the family members were instructed to inject 50-100ml normal saline into the bladder from the fistulas every day for bladder irrigation. If there was obstruction, sterile syringe could be used for suction and squeezing. If it was still obstructed, 20ml sterile saline could be injected through the fistulas. The obstruction was first flushed into the bladder and then drained out. If the drainage fluid is turbid and there are many necrotic and exfoliated tissues, it indicates that there is infection in the bladder. The bladder can be washed intermittently with normal saline 500ml + gentamicin 240000u twice a day until the urine is clear. 4. It is not suitable for continuous urination through fistula tube. Continuous urination can cause disuse atrophy of bladder detrusor and eventually cause bladder spasm. Generally, urination is performed once every 2-3 hours to maintain bladder self-regulation. 5. Use iodophor cotton ball daily to disinfect the skin of stoma, remove secretions and cover with sterile dressing.
