Plastic surgeons come into picture in treatment for vaginal fistula and anal incontinence when all the other options for healing the area and the fistula.
Plastic surgeons come into picture in treatment for vaginal fistula and anal incontinence when all the other options for healing the area and the fistula and anal sphincter correction are exhausted by the surgeons, gynecologists and the urologist
A vaginal fistula is an unusual opening that connects vagina to another organ in females like rectum, bladder, urethra, ureter and small & large intestine. We would like to limit our discussion for management of fistula connecting vagina with the rectum or the bladder
Out of all these above-mentioned locations of fistula, Plastic surgeons contribute in the management ofrectum or difficult recurrent bladder fistulae. Fistulas at the higher locations within the abdomen region are managed by Urologists and general surgeons.
The main reason is tissue damage because of :
Symptoms of Vaginal Fistula
Vaginal fistulas arevery embarrassing to women when they leak and cause bad smells.
Diagnosis of Vaginal Fistula
A pelvic exam is a must and details about medical and surgical history to see any risk factors for fistulas, like a recent surgery, infection, or radiation.
Few investigations are advised to confirm the diagnosis of fistula, its path, numbers and extent:
Treatment of Vaginal Fistula
The margins of the fistula and its surrounding area is inflamed and scarred and does not hold sutures good and tightand thus repairs are liable to give up and form fistula again. Dr Amit Agarwal bring in healthy tissues from the thigh in form of a muscle and well vascularised pedicled flap to inset between the rectum and the vagina so that the area can heal properly.
The surgery is usually done in lithotomy position only usually completed within an hour or 2 hours.
Anal incontinence is one of the most psychologically and socially embarrassing conditions in men and women lead in to social isolation, loss of self-esteem, self-confidence and depression.
Anal incontinence is the inability to voluntarily exert control and expel the passage of bowel contents at a socially acceptable location and time in both and women over the age of four years.
Anal incontinence is thought to be very common, but much under reported due to embarrassment.
Causes of Anal incontinence
Diagnosis of Anal incontinence
The diagnosis was made with a –
Treatment of Anal incontinence
After routine investigations, the patient is usually posted for surgery and in lithotomy position, the perineal tear or anal sphincter is repairedif the margin ofthe cut muscle sphincter are visible and the area of damage is limitedand not widespread with less scarring. This repair is usually done by gynaecologists or general surgeons.
Plastic surgeons contribute in the management of anal incontinence when initial surgical management has failed or the area of scar and damage is too extensive to be repaired with the help of local tissues.Management of anal incontinence is usually achieved with the help of gracilis sling operation around the anal sphincter.
The muscle does not seem to act as a dynamic sphincter but does offer passive resistance to outflow of bowel contents. The muscle acts as an inert sling with a success rate between 60 to 90 percent.
The surgery is usually done under regional anaesthesia and in lithotomy position. Dr Amit Agarwal usesgracilis muscle from thethigh for encircling the anal sphincterwhich is harvested by a longitudinal incision given on the medial aspect of thigh. The tendon of the muscle is brought into the perianal tunnel at the sides and back of the anorectal region. The muscle is wrapped around the anal canal, and then forcibly drawn forwards again to be reattached by nylon 1/0 stitches to periosteum of lower surface of ischial tuberosity bone. Digital examination after the sling is created confirms that a finger could be inserted easily and had the sensation of being firmly gripped.
Post-surgery, patients go through a period of training with exercises to learn to voluntarily contract and relax the muscle. The muscle contracts with abduction of the thigh and can be made to relax by assuming the squatting position to avoid abduction of the leg.
Best plastic surgeon, Dr. Amit Agarwal is an American Board Certified, extensively trained, and best Plastic & Aesthetic surgeon in Lucknow. He is the Chief Plastic Surgeon heading the Department of Plastic, Microvascular, and Craniofacial surgery at Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, U.P, India. He maintains a busy practice at Avadh and Nishat Hospital and his own center - Kayakriti Plastic Surgery & Dental Center. He was formerly a Consultant in the Department of Plastic Surgery and Burns at the prestigious SGPGI, Lucknow.
We believe your experience with us should be comfortable and hassle-free to make it one of your best lifetime experiences for yours. We, here at the clinic, take full precautions to maintain your privacy in any manner. We also provide a staff who will receive you from the gate and take you to the chamber directly if you demand.
Our Surgeon is highly qualified and internationally certified with a team of skilled staff to perform any surgical or non-surgical treatment on your body.
When you plan to undergo any surgery you should always keep in mind that it's your body and it's a surgery. We, here always keep your safety a priority and will never recommend you to undergo any such procedure which is not safe for you. We also provide you with a detailed description of the complications which may occur after the surgery during the consultation as it's a surgical procedure so there may be some complications depending on the way your body reacts.
If you have flat or small breast and you want to improve your breast and hip contour ratio then you are a good candidate for it. The answer will be best provided after the first consultation with Dr Amit Agarwal.
Acute pain will be there for almost a week which gradually reduces and there will be soreness and swelling which may take up to 3 weeks to subside.
You can join your work and daily routines after a week of the procedure and can start exercising after 3 weeks of it.
Yes, you have to wear it round the clock unless we suggest you to remove it.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
D-43, Near Punjab National Bank, Rajajipuram, Lucknow, Uttar Pradesh - 226017, India
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