Genitourinary Fistulas – Our Experience

Abstract

Introduction: Urogenital fistula is a physically, socially and psychologically devastating condition. Although advances occurred in the understanding of etiology, pathogenesis, diagnosis, and management, it still poses challenges to the treating surgeon because of the controversies regarding the optimum time of repair and the ideal surgical approach. The objective of our study was to review cases of urogenital fistulae referred to our department over a 4-year period, with respect to etiology, types, management and outcome. Material and methods: This was a retrospective observational study between January 2013 to January 2017 which reviewed patient charts undergoing Genitourinary fistula repair at our Institute SVIMS, Tirupati for etiology, site, size and number of fistulae, clinical presentation, diagnostic modalities, and management. Results: A total of 49 women underwent genitourinary fistula repair at our institute between January 2013 to January 2017. The mean age of the patients was 39 years (19-58). Out of 49 cases, 35 cases were vesicovaginal fistulae (VVF), 3 fistulae were ureterovaginal, two fistulae were both VVF and ureterovaginal,7 fistulae were urethrovaginal and one vesicouterine fistula. Conclusion: Genitourinary fistulas are socially debilitating. High rates of successful fistula closure can be achieved irrespective of etiology by following sound surgical principles of fistula repair.

Predictive Factors for Post-Operative Bleeding in Percutaneous Nephrolithotomy.

“…But post PCNL bleeding factors are controversial. [6,8,9] Previous ipsilateral open surgery increased the bleeding in a study conducted by Yesil et al, [10] which was not so according to the study by Kukreja et al, [11]. In our study too, there was no increased incidence of bleeding in patients who had undergone previous renal surgery.…”