Fistula Vesiko Vaginalis
DOI:
https://doi.org/10.25077/jka.v5i2.543Abstract
Abstrak         Latar belakang : fistula vesiko vaginalis merupakan bagian dari fistula vesiko urogenital merupakansuatu keadaan ditandai fistel antara kandung kemih dengan vagina yang menyebabkan rembesan urin keluar melalui vagina.
         Kasus : wanita P3A0H3, 44 tahun, datang dengan keluhan terasa rembesan buang air kecil dari kemaluan sejak 3 bulan yang lalu. Keluhan muncul 7 hari setelah menajalani operasi histerektomi 3 bulan yang lalu. Histerektomi dilakukan atas indikasi mioma uteri dilakukan di Rumah Sakit Swasta. Tanda vital dalam batas normal. Pada pemeriksaan inspekulo tampak cairan urin menumpuk di fornix posterior. Dilakukan prosedur tes methylene blue didapatkan hasil positif di puncak vagina anterior 1 fistel dengan ukuran 1-1,5 cm. Pada pasien dilakukan fistulorraphy vesikovagina dengan teknik repair latzko dalam spinal anasthesi.
         Pembahasan : Kasus fistula vesiko vaginalis biasa muncul di negara berkembang. Diantara faktor predisposisi adalah disebabkan operasi histerektomi, selain itu trauma persalinan dan komplikasi operasi daerah pelvik. Pemeriksaan Fisik dan pemeriksaan tambahan secara konvensional atau minimal invasif seperti sistoskopi, sistografi menggunakan zat kontras bisa membantu menegakan diagnosa, menentukan lokasi, ukuran dan jumlah fistel. Pembedahan adalah terapi andalan untuk fistula urogenital melalui transvagina atau trans abdomen. Pendekatan terapi tergantung ilmu, pengalaman dan kolaborasi dengan ahli lain bila dibutuhkan.
Kata kunci: fistula vesiko vaginalis, histerektomi, latzko
Abstract
Background : Vesica vagina fistula is a part of urogenital fistula wich condition that present fistula between bladder and vagina and make urine mold through vagina.
Case Report: Woman P3A0H3, 44 years old, admitted with complaining mold of urine from vagina since three months ago after seven days having surgery procedure. Complaint appeared seven days after histerctomi procedure. The procedure do as indication myoma uterus, the procedure has done in Private Hospital. The vital signs are normal. On Per Speculum examination, clearly see there are fluids on fornix posterior. methylene blue tes has proceed and get the positive result. Fistula is at the top anterior of vagina, about 1-1,5 cm. Surgery procedure fistulorraphy vesica vagina with latzko technique under Spinal Anesthesia has performed
Discussion : Vesica vagina fistula usually occur in the development country. Predisposition factors of it caused by histerectomi procedure, besides trauma during labour and complication of pelvic surgery may also too. Physical and additional specific examination conventionally or minimal invasive like cystoscopy, cystography with contrast can obtain diagnose, determine the location, size and number of fistula. Surgery is the mainstay therapy for urogenital fistula through trans vagina or trans abdomen. Approaching depend on knowledge, experience and collaboration with other expert if needed.
Keywords: Vesica vagina fistula, histerectomy, latzko
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