This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
[{'content': 'Postpartum VVF is best repaired after: \nSelect and explain. \nA. 6 weeks, B. 8 weeks, C. 3 months, D. 6 months', 'role': 'user'}, {'content': 'Answer: C \nExplanation: Management of VVF is surgical management:\nThe timing of surgery -\n\n\nSmall urinary fistulas sometimes heal spontaneously during the first few weeks.\n\n\nHowever, in a case of established fistula - it is better to wait for about 3 months° for all tissue inflammation to subside. If one attempt fails to heal fistula, the second attempt is done after 3 months.°\n\n\nIn fistulas following surgery, waiting period is 3-6 months.\n\n\nIn fistulas following radiation: 6 months - 2 years time can be taken before inflammation subsides.\n\n\nTechniques of Repair -\n\n\nLayer technique\n\n\nLatzko procedure (for fistulas following hysterectomy)\n\n\nChassar Moir technique.\n\n\nPost-operative Management -\n\n\nContinuous bladder drainage for 14 days.\n\n\nAntibiotic coverage.\n\n\nNo vaginal examination, P/S, intercourse x 3 months.\n\n\nAvoid pregnancy for 2 years.\n\n\nIn pregnancy after repair of vaginal fistula - elective cesarean is done.\n\n\nExtra Edge:\nThis question is an old one so here answer will be 3 months but if this question is repeated now remember the following lines from Williams Gynae. 1st /ed 575-576:\n"Timing of repair: Traditional teaching recommends delayed repair of fistulas at 3 - 6 months after injury. However, this old dictum is probably no longer applicable. Most agree that unless there is a severe infection or acute signs of inflammation, waiting is not necessary. Early surgical intervention of uncomplicated fistulas does not affect closure\xa0rates, yet appears to reduce social and psychological patient distress (Balivas, 1995). Fistulas identified within the first 24 - 48 hours postoperatively can be safely repaired immediately with success rates of 90 - 100%."', 'role': 'assistant'}]