She presented with uncontrollable drippling of urine per vaginal of 7 months duration.

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Emobileclinic Patient’s corner 

Emobileclinic Specialist 

Her problem started 8 days after an abdominal delivery at a private Hospital. She was in labour for two days at home under supervision of a traditional birth attendant before she was taken to a private Hospital and delivered of a still birth infant via abdominal route. She was on urethral catheter for 8 days. She noticed the urinary incontinence immediately following removal of the catheter. What is the causes of her urine drippling? 

semen quality pic

At further examination,  there was no associated urge to void and no associated faecal incontinence. There was loin pain and no fever since onset of symptoms. She had not sought any help for the problem because of financial difficulties. She was yet to resume menses since the childbirth. She attained menarche at about 15 years of age and her menstrual cycle was 28-30 days with flow of 4-5days regular and of normal flow. She has 7 lives deliveries and one dead.

gyno

At vaginal examination, there was a strong amnoniacal smell. The thick perineal cloth was soaked and the urine was seen trickling from the introitus. There was no excoriation on the vulva and perineum. The vaginal admitted two fingers comfortably. There was a defect felt in upper third of  the anterior vaginal wall. It admitted the tip of the finger. The cervix was closed, firm and central. The uterus was normal and in anteverted position. Adnexae were free and the pouch of Douglas was empty. 

Diagnosis 

Vesico-vaginal fistulae from pressure necrosis 



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