Cervical cancer is one of the commonest gynecological malignancies
all over the world. It can be cured if identified early. Most of the cervical
cancers are squamous carcinomas. Squamous carcinomas are highly sensitive to
radiotherapy. Therefore, radiotherapy for cervical carcinoma plays a major role
in treating cervical cancers. As with any other treatment modality,
radiotherapy also has its own set of complication. Fistula formation is one
such complication.
A fistula can develop between the bladder and the perineal
skin. This occurs as a result of avascular necrosis of the tissues surrounding
the bladder. Unfortunately, the fistulas can occur several years after the
radiotherapy. The cancer might have disappeared completely by then. Sometimes ureterovaginal fistula (Between the ureter
and the vagina) can coexist with viscicovaginal fistula (between the bladder
and the vagina). Therefore, several investigations are done to differentiate
one from another. Three swab test is one such investigation.
The three swab test is done by inserting a swab into the
vagina and injecting a die through the urethra. The swab will stain with the
die, if there is a viscicovaginal fistula. An intravenous urogram (IVU) should
be performed to exclude a coexisting ureterovaginal fistula.
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