Experience of our surgery in iatrogenic vesicovaginal fistulas

Karateke, Ateş; Asoğlu, Mehmet Reşit; Selçuk, Selçuk; Çam, Çetin; Tuğ, Niyazi; Özdemir, Armağan

doi:10.5152/jtgga.2010.20

Cited by 3 publications

(3 citation statements)

References 26 publications

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“…The mean age of the patients in the present study was 37.05 ±8.08 years. In recent studies by Wadie and Kamal ( 15 ) in 2011 and Karateke et al in 2010 ( 16 ), the median age at presentation was >35 years, which is similar to the present study. Wall et al ( 17 ) in 2004 reported a higher incidence of VVF in a younger population; the mean age was 27 years (range, 13-20 years).…”

Section: Discussionsupporting

confidence: 92%

Urinary fistula-A continuing problem with changing trends

Kumar

Vatsa

Bharti

et al. 2017

J Turkish German Gynecol AssocJ Turkish German Gynecol Assoc

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Objective:Urinary fistula is a distressing complication after difficult vaginal deliveries, obstetric, and gynecologic surgeries. The present study describes a single center’s experience in the management of urinary fistula at a tertiary care hospital. It was performed to analyze the etiology of genitourinary fistula, to assess the outcome after surgical repair, and to determine the changing trends in the etiology and management of urinary fistula.Material and Methods:This retrospective study was conducted over 5 years in the department of obstetrics and gynecology, All India Institute of Medical Sciences, New Delhi. Twenty patients who underwent surgical repair of urinary fistula were included in the study and analyzed for their etiology, presentation, site, size, previous failed repair, approach of surgical repair, and outcome. The findings of the present study were compared with a previous study at our center to determine the changing trends of urinary fistula.Results:The mean age of the study population was 37.05±8.08 years. The majority (65%) of the fistulae occurred following gynecologic surgeries, whereas 25% were due to obstructed labor, and 10% after cesarean section for other indications. The vaginal approach was used in all except one case of uterovesical fistula, which was repaired abdominally. The outcome was successful in 85% of cases. The success rate was similar in primary versus previous failed repair (p=0.270).Conclusion:The most common cause of urinary fistula in the present study was gynecologic surgery. The vaginal approach can be used even in cases with previous failed repairs with a high success rate.

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Section: Discussionsupporting

confidence: 92%

Urinary fistula-A continuing problem with changing trends

Kumar

Vatsa

Bharti

et al. 2017

J Turkish German Gynecol AssocJ Turkish German Gynecol Assoc

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“…The age of the subjects in this study ranged from 13-55 years with a mean of 28±11.1 years. This is similar to the findings of Kumar et al, Karateke et al and Amitava et al [12][13][14] This age range is within the child-bearing age of women as well as the age when obstetric and gynaecologic surgeries are most commonly performed. The youngest patient in this study was 13 years at the time of presentation.…”

Section: Discussionsupporting

confidence: 91%

Management of complex genital fistula: experience in a tertiary sub-Saharan hospital

et al. 2020

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Background: Management of complex genital fistulae is challenging due to the cost and technical skill required. This study reports our experience in the management of patients with complex genital fistulae and to highlight the crucial role of the reconstructive urologists.Methods: This was a retrospective review of female patients managed at a tertiary hospital in Nigeria from 2006 to 2017 for complex urinary fistulae. Data were extracted from patient case notes and the data analysed using the SPSS software.Results: Twenty-four female patients mean age 28.9±11.1 years. Fistulae resulted from prolonged obstructed labour 10 (41.6%), caesarean hysterectomy 7 (29.2%), caesarean section and abdominal hysterectomy 2 (8.4%) respectively. The fistulae were vesicovaginal 16 (66.7%), ureterovaginal 3 (12.5%). Others were vesicocutaneous, urethrovaginal and rectovaginal. Prior attempts at repair were done in 7 (29.2%) and the number of attempts ranged from 1 to 4. Surgical procedures included direct closure in 9 (37.5%), closure and uretero-neocystostomy 7 (29.2%), uretero-neocystostomy only 3 (12.5%) closure and abdominal hysterectomy 2 (8.3%), closure and continent catheterizable neo-bladder 2 (8.3%) and 1 (4.2%) closure, abdominal hysterectomy and uretero-neocystostomy. Post-operative complications were noted in 2 (8.3%) and consisted of gynaeatresia and recurrent RVF. Repair was successful in 70.8% of patients while failed repair was recorded in 16.7% and while stress incontinence was present in 12.5%.Conclusions: Complex genital fistulae in our practice are of obstetric origin involving the bladder, ureters and rectum. The reconstructive urologist has a crucial role the management for a favourable outcome.

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“…5 However, the Þ stula patients pose a considerable challenge for the surgeon in terms of success due to multiple factors responsible for the success(type of Þ stula, previous repair attempt, parity, size of Þ stula, accessibility). 6,7 Among those, history of previous repair attempts has been reported to be the most consistently related to the success of Þ stula repair. 8,9 As prior knowledge of the predictors of success helps to counsel the patient and to individualize the management, we did a retrospective analysis on prospectively collected data of patients who attended our center for urogenital Þ stula management.…”

Section: Introductionmentioning

confidence: 99%

Success Rate of Urogenital Fistula Repair and Predictors of Success-An Audit of Ten Years Data

Tasnim

Bangash

Amin

et al. 2018

Nepal J Obstet Gynaecol

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Aims: To evaluate the association of various predictive factors with the outcome of surgical repair of vesicovaginal fistula. Methods: The retrospective analysis was conducted at Maternal and Child Health, Pakistan Institute of Medical Sciences, Islamabad, and it comprised data related to patients having undergone vesicovaginal fistula repair from January 2008 to June 2018. Statistical analysis of the record was done using SPSS 21 software. Results: A total of 364 patients of urogenital fistula repair were reviewed, with an overall success in 318 (87.4%) cases. There were no significant differences in fistula duration (p0.4), size of fistula (p 0.34) and accessibility (p0.5) between successful and unsuccessful group. However, we found the association between the type of fistula and history of previous repair attempts with the success of fistula repair. Primary surgical repair of vesicovaginal (90.0%), vesicouterine (86%), ureteric (100%) and ureterovaginal (98%) were more successful as compared to repair with the history of 1 previous attempt (90.3%, 83.3%, 66.6% and 75% respectively). Success rate was found to further decrease with the history of more than one repair attempt of vesicovaginal (71.4%) and vesicouterine (66.5%) fistula. Further, successful fistula repair in women was also found to be significantly associated with parity less than 4 (p 0.038). Conclusion: Despite the higher success rate of urogenital fistula repair, it’s important to refer the urogenital fistula patients timely to specialized fistula centres in order to achieve best results.

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Experience of our surgery in iatrogenic vesicovaginal fistulas

Cited by 3 publications

References 26 publications

Urinary fistula-A continuing problem with changing trends

Urinary fistula-A continuing problem with changing trends

Management of complex genital fistula: experience in a tertiary sub-Saharan hospital

Success Rate of Urogenital Fistula Repair and Predictors of Success-An Audit of Ten Years Data

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