Retrograde vaginal methylene blue injection for localization of complex urinary fistulas.
BACKGROUND
Ureterovesical and vesicovaginal fistulae usually are easily diagnosed with standard techniques, including radiology, double-dye test, cystoscopy, and vaginal examination. In a few complex cases, however, the localization of the fistulous orifice may be extremely difficult.


METHODS
We describe a novel technique of retrograde vaginal methylene blue testing that may assist in the proper localization of the fistulous opening.


RESULTS
Our experience with one case each of ureterovesical and vesicovaginal fistula easily diagnosed with this method proves its efficacy, simplicity, and safety.


CONCLUSIONS
This technique should be reserved for cases of urinary fistulae when all standard diagnostic methods have failed.
Hanash
Kamal A
KA
Department of Urology-MBC 83, King Faisal Specialist Hospital & Research Centre, PO Box 3254, Riyadh 11211, Saudi Arabia. khanash@kfshrc.edu.sa
Al Zahrani
Hassan
H
Mokhtar
Alaa A
AA
Aslam
Muhammad
M
D000328:Adult; D003558:Cystoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008751:Methylene Blue; D008875:Middle Aged; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014548:Urinary Fistula / Q000175:diagnosis; D013519:Urogenital Surgical Procedures / Q000379:methods; D014567:Urography / Q000379:methods; D014719:Vesicovaginal Fistula / Q000175:diagnosis*
D008751:Methylene Blue