Vaginal Fistula: Etiology, Pathophysiology, and Clinical Manifestations

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What is the purpose of using a pessary for a patient with uterine prolapse?

To prevent the uterus from becoming further prolapsed
To increase the patient's sexual activity
To clean and replace the vaginal walls
To manually reposition the uterus (correct)

What is the recommended frequency for cleaning and replacing a pessary?

As needed, based on the patient's symptoms
Every 6 months
Every 3-4 months (correct)
Every 1-2 years

What is the definition of a rectocele?

Protrusion of the urethra into the vagina
Protrusion of the rectum into the vagina (correct)
Protrusion of the bladder into the vagina
Protrusion of the small bowel into the vagina

What is the recommended surgical treatment for a completely prolapsed uterus?

Vaginal hysterectomy (D) Signup and view all the answers

What is the most common cause of uterine prolapse?

Trauma from childbirth (A) Signup and view all the answers

What is the definition of a retroversion of the uterus?

The uterus is aligned with the vagina and points towards the sacrum (C) Signup and view all the answers

What is the most common symptom of a cystocele?

Urinary urgency and incontinence (C) Signup and view all the answers

What is the recommended waiting period before attempting surgical repair of a vaginal fistula?

4-6 months (B) Signup and view all the answers

What is the purpose of performing a uterine suspension surgery?

To reposition a prolapsed uterus (D) Signup and view all the answers

What is the most severe form of uterine prolapse?

Severe prolapse where the entire cervix protrudes through the vaginal opening (D) Signup and view all the answers

What is the most common benign tumor of the female genital tract?

Leiomyomas (C) Signup and view all the answers

Which surgical intervention maintains fertility by removing uterine myomas while leaving the uterus in place?

Myomectomy (A) Signup and view all the answers

What is one of the risk factors associated with leiomyomas?

Obesity (C) Signup and view all the answers

What is the purpose of injecting embolic material into the uterine artery during uterine artery embolization?

To reduce blood flow to the tumor (D) Signup and view all the answers

What is a common clinical manifestation of leiomyomas?

Urinary frequency/urgency (B) Signup and view all the answers

Which medication is often given to shrink tumors before surgical intervention for leiomyomas?

Gonadotropin-releasing hormone agonist (C) Signup and view all the answers

What is the estimated reoccurrence rate of prolapse after surgical correction?

~20% (D) Signup and view all the answers

What dietary intake is associated with an increased risk of leiomyomas?

High intake of red meat and pork (D) Signup and view all the answers

What is the common name for anteroposterior colporrhaphy?

Bladder sling surgery (A) Signup and view all the answers

What is a vaginal fistula?

An abnormal opening between the vagina and another organ (A) Signup and view all the answers

What can cause a vaginal fistula?

All of the above (D) Signup and view all the answers

What is a urethrovaginal fistula?

An opening between the urethra and the vagina (C) Signup and view all the answers

What is a common clinical manifestation of a vaginal fistula?

Exudate with a distinct odor of urine or feces (B) Signup and view all the answers

What is a common symptom reported by patients with a vesicovaginal fistula?

Constant trickling of urine into the vagina (C) Signup and view all the answers

How can a rectovaginal fistula be recognized?

Feces and flatus entering the vagina (D) Signup and view all the answers

What is a diagnostic test that can be used to locate a vaginal fistula?

Methylene blue instillation in the bladder and IV pyelogram or cystoscopy (D) Signup and view all the answers

What is a conservative management option for smaller vaginal fistulas?

Transvaginal or transvesical application of a fibrin glue sealant (A) Signup and view all the answers

What type of diet is recommended for patients with vaginal fistulas?

High-protein, high-fiber diet (A) Signup and view all the answers

What is a potential surgical intervention for larger vaginal fistulas?

Urinary or bowel diversion (ostomy) (A) Signup and view all the answers