You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is Kamla, a 48 years old lady underwent hysterectomy on the seventh day. She developed fever burning micturition and continuous urinary dribbling. She can also pass urine voluntarily. The diagnosis is- and explain in detail?
Ans. is 'd' Uretherovaginal fistula (Ref. Shaws, 13/e, p 181 (12th/e, p. 149)). History of previous operation (hysterectomy) and the symptom (Continuous dribbling of urine in the patient) has made it very easy for us to rule out stress incontinence and urge incontinence. Continuous dribbling of urine is a classic feature of urinary fistulas and they are common after gynecological operations. In stress incontinence, dribbling of urine occurs only when intraabdominal pressure is raised. In urge continence, the patient must pass urine at a moment's notice and unless she is quick about it she is unable to control her bladder. Now we are left with 2 options uretherovaginal fistula and vesicovaginal fistula. The passing of urine voluntarily clinches the diagnosis in favor of uretherovaginal fistula as voluntary passing of urine is seen only in ureterovaginal fistula. In vescico vaginal fistula no urine allowed to collect in the bladder.