Double dye test is useful for diagnosing vesicovaginal or ureterovaginal

fistula A fistula (plural: fistulas or fistulae ; from Latin ''fistula'', "tube, pipe") in anatomy is an abnormal connection between two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow or ...

e. For this test, the patient takes oral

phenazopyridine Phenazopyridine is a medication which, when excreted by the kidneys into the urine, has a local analgesic effect on the urinary tract. It is often used to help with the pain, irritation, or urgency caused by urinary tract infections, surgery, or ...

(Pyridium) 200 mg three times a day, and

indigo carmine Indigo carmine, or 5,5′-indigodisulfonic acid sodium salt, is an organic salt derived from indigo by aromatic sulfonation, which renders the compound soluble in water. It is approved for use as a food colorant in the U.S and E.U. to produce a ...

methylene blue Methylthioninium chloride, commonly called methylene blue, is a salt used as a dye and as a medication. Methylene blue is a thiazine dye. As a medication, it is mainly used to treat methemoglobinemia by converting the ferric iron in hemoglobin ...

is filled into the empty

urinary bladder The urinary bladder, or simply bladder, is a hollow organ in humans and other vertebrates that stores urine from the kidneys before disposal by urination. In humans the bladder is a distensible organ that sits on the pelvic floor. Urine enters ...

via a urethral

catheter In medicine, a catheter (/ˈkæθətər/) is a thin tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. Cath ...

Pyridium Phenazopyridine is a medication which, when excreted by the kidneys into the urine, has a local analgesic effect on the urinary tract. It is often used to help with the pain, irritation, or urgency caused by urinary tract infections, surgery, or ...

turns urine orange in the kidneys, and methylene blue (or indigo carmine) turns urine blue in the bladder. A

tampon A tampon is a feminine hygiene, menstrual product designed to absorb blood and vaginal secretions by insertion into the vagina during menstruation. Unlike a Sanitary napkin, pad, it is placed internally, inside of the vaginal canal. Once inser ...

is placed into the

vagina In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hymen ...

. If the tampon turns blue, vesicovaginal fistula is suspected. If the tampon turns orange, ureterovaginal fistula is suspected. If the tampon turns blue and orange, suspect a combination of vesicovaginal and ureterovaginal fistulae. It is important to be alert for leakage around the catheter, which may spill back into the vagina creating the false impression of a fistula. It is also important to ensure that adequate distension of the bladder occurs as some fistulae do not leak at small volumes; conversely, some fistulae with an oblique track through the bladder wall may leak at small volumes, but not at capacity. Direct inspection of leaking dye in vagina in

lithotomy position The lithotomy position is a common position for surgical procedures and medical examinations involving the pelvis and lower abdomen, as well as a common position for childbirth in Western nations. The lithotomy position involves the positioning of ...

is better than the traditional 'three swab test' as multiple fistulae may be located in this way.

References

External links

Vaginal fistula
from

Mayo Clinic The Mayo Clinic () is a nonprofit American academic medical center focused on integrated health care, education, and research. It employs over 4,500 physicians and scientists, along with another 58,400 administrative and allied health staff, ...

References

External links

See also