Divya Ajay Archives

Divya Ajay

Robotic GU Fistula Repair

Posted by Divya Ajay, MD, MPH | Sep 2024

Divya Ajay, MD, MPH, covers diagnosing and managing genitourinary (GU) fistulas, emphasizing the complexity and challenges involved. Fistulas can occur throughout the urinary system, affecting the lower and upper tracts. Common causes include gynecological surgeries, cancer treatments, radiation, and infections.

In this 24-minute presentation, Dr. Ajay discusses vesicovaginal, urethral, and colovesical fistulas, with treatment strategies varying based on fistula type and patient condition. Ajay shares several surgical approaches, including robotic, vaginal, and open surgeries, tailored to the fistula’s location and severity. Ultimately, successful outcomes depend on precise diagnosis, appropriate surgical technique, and postoperative management.

Lower Ureteroplasty – Reimplants, Hitch, Boari Flap

Posted by Divya Ajay, MD, MPH | Sep 2024

Divya Ajay, MD, MPH, focuses on strategies and considerations for lower ureteroplasty, emphasizing meticulous surgical technique and patient management.

In this 13-minute presentation, Dr. Ajay addresses various causes of ureteral pathology, including trauma, stones, infections, and malignancy. She stresses that successful outcomes depend on detailed preoperative planning, including a thorough understanding of stricture length after removing stents to avoid incomplete assessment.
Ajay outlines common surgical strategies with videos of procedures, including psoas hitch and Boari flap for distal ureteral reconstruction, and advocates for individualized approaches based on anatomy and patient history. The use of stents is debated, with newer evidence suggesting fewer complications in select cases when stents are avoided, though caution is recommended in complex or radiated patients.