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Vesicovaginal Fistula Repair Case Study #1
California Doctor Flies to Atlanta for Her Vesicovaginal
Fistula Rapair After Failed Surgery at UCLA
Fistula Symptoms: Urinary leakage through vagina
Initial Cause of Fistula: Cesarean Section (January 2011)
Failed Attempt to Repair Fistula: 1x vesicovaginal fistula repair failed by doctors at UCLA Medical Center (March 2011)
This patient is a 38-year-old female doctor from San Diego, CA, who is a specialist in infectious disease, with a diagnosis of a vesicovaginal fistula (VVF). Her fistula has persisted since the delivery of her child by an emergent Cesarean section approximately 10 months ago. At that time the patient had a rare uterine and placenta (after birth) problem known as placenta percreta. Patients with this condition cannot deliver the afterbirth because the placenta has grown through the wall of the uterus instead of just normally attaching to it. In normal patients the placenta detaches from the uterus and is delivered after the child is birthed….thus the name after birth. In patients with placenta percreta the only way for the placenta to be removed is to remove the uterus (aka hysterectomy). This is an emergent situation and not removing the uterus will 99% of the time result in death to the mother. After 25 units of blood and removal of the uterus and weeks in the intensive care unit the patient survived but unfortunately was left with a fistula between her vagina and bladder (ie vesicovaginal fistula).
The patient contacted Dr. Miklos to discuss her problem at that time she considered coming to Atlanta to have her surgery. She even contacted one of the directors of female urology at the Cleveland Clinic in Cleveland OH and discussed Dr. Miklos' technique and capabilities in performing a laparoscopic VVF procedure. The urologist suggested she see Dr. Miklos or the director of female urology at UCLA in California. After seeing the urologist at UCLA she was told the approach to her repair would be performed via a vaginal approach and not laparoscopic since they do not have much experience performing this surgery laparoscopically at UCLA. The patient explained that because of her children and the long trip to Georgia she made a decision to have her surgery at UCLA. Dr. Miklos explained to the patient he understood that logistics were a problem and if she felt more comfortable having her surgery in California then she should proceed there. He also explained if the procedure was not successful she could always come to Atlanta for a redo of the failed VVF repair.
She had a transvaginal VVF repair on March 24, 2011 at UCLA. She claims that less than 4 weeks after the procedure she started to notice urine leaking from her vagina. She called Dr. Miklos in early August to explain her situation. Unfortunately her first VVF repair performed at UCLA failed. She flew to Atlanta on August 15th and had her surgery with Dr. Miklos & Moore on August 16, 2011. The surgery was completed without complication and the patient flew back to San Diego on August 20th. Her catheter was removed 3 weeks later and she has been dry ever since.
The redo VVF repair performed by Dr Miklos & Moore is an absolute success!!
The patient is CURED!
