When the methylene blue dye is injected into the bladder through a catheter and the dye is seen escaping through the vaginal opening the condition is due to
A. Uterine prolapsed
B. Recto-vaginal fistula
C. Fibroid uterus
D. Vesicovaginal fistula
Correct Answer: C. Fibroid uterus
Explanation
When methylene blue dye is instilled into the bladder through a catheter and the dye is seen leaking out through the vagina, this indicates:
✅ Vesicovaginal Fistula (VVF)
Explanation:
- A vesicovaginal fistula is an abnormal connection between the bladder and the vagina.
- When dye is placed in the bladder, it escapes through this abnormal tract and appears in the vagina.
- This confirms the diagnosis of VVF.
Key point:
Leakage of methylene blue dye from the vagina after bladder instillation is a diagnostic sign of vesicovaginal fistula.
Other Options Details
Here are clear, concise descriptions of each option:
A. Uterine Prolapse
Uterine prolapse occurs when the uterus descends from its normal position into the vagina due to weakening of pelvic floor muscles and ligaments.
Causes: childbirth trauma, aging, menopause, chronic coughing, obesity.
Symptoms: pelvic pressure, a feeling of “something coming down,” backache, urinary problems.
B. Recto-vaginal Fistula
A recto-vaginal fistula is an abnormal communication between the rectum and vagina, allowing feces or gas to pass through the vagina.
Causes: childbirth injury, trauma, Crohn’s disease, surgery, infections.
Symptoms: passage of stool/gas through vagina, recurrent infections, foul discharge.
C. Fibroid Uterus
A fibroid uterus means the uterus contains fibroids (leiomyomas)—benign smooth-muscle tumors.
Types: submucosal, intramural, subserosal.
Symptoms: heavy menstruation, pelvic pain, infertility, abdominal mass (in some cases).
Fibroids are non-cancerous and are influenced by estrogen.
D. Vesicovaginal Fistula (VVF)
A vesicovaginal fistula is an abnormal connection between the bladder and vagina, causing continuous leakage of urine through the vagina.
Causes: obstructed labor, pelvic surgeries (especially hysterectomy), radiation.
Symptoms: persistent watery vaginal discharge, urinary incontinence, irritation.
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Writer: Vandita Singh, Lucknow (GS India Nursing Group