2015
DOI: 10.5301/uro.5000112
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Repair of post-hysterectomy vesicovaginal fistulae: the state of the art

Abstract: In western countries, vesicovaginal fistulae (VVF) are mostly iatrogenic and in the majority of cases are secondary to hysterectomy. The golden standard for the treatment of VVF has remained largely unchanged since 1953 (Couvelaire): good visualization, good dissection, good approximation of the margins, and good urine drainage. However, several aspects are still being debated, including whether or not to pursue conservative repair, the timing for surgical repair, whether to perform excision of the fistula tra… Show more

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Cited by 5 publications
(3 citation statements)
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References 99 publications
(115 reference statements)
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“…However, for open surgery or laparoscopic repair, patients are generally required to wait 10-12 weeks; during this period, the local inflammation of the fistula subsides, the scar softens, and the local tissue obtains adequate blood supply, leading to the best possible surgical conditions ( 13 , 18 ). However, during this time, patients continue to endure the physical and mental distress of urinary leakage, which significantly affects their quality of life ( 11 , 19 ). Traditional repair surgery, whether through the abdominal, bladder, or vaginal route, causes secondary trauma and carries a risk of complications, such as fistula recurrence, urinary incontinence, vaginismus, and bladder spasm ( 9 , 12 ).…”
Section: Discussionmentioning
confidence: 99%
“…However, for open surgery or laparoscopic repair, patients are generally required to wait 10-12 weeks; during this period, the local inflammation of the fistula subsides, the scar softens, and the local tissue obtains adequate blood supply, leading to the best possible surgical conditions ( 13 , 18 ). However, during this time, patients continue to endure the physical and mental distress of urinary leakage, which significantly affects their quality of life ( 11 , 19 ). Traditional repair surgery, whether through the abdominal, bladder, or vaginal route, causes secondary trauma and carries a risk of complications, such as fistula recurrence, urinary incontinence, vaginismus, and bladder spasm ( 9 , 12 ).…”
Section: Discussionmentioning
confidence: 99%
“…(3) Existe otra clasificación que las divide en pequeñas, intermedias y grandes, definiendo cada una como <0.5cm, 0.6cm a 2.4cm, >2.5cm respectivamente. (4) El mejor tratamiento de esta patología es reconocer la lesión y repararla en el primer procedimiento, si se diagnostica en las primeras semanas -después de la cirugía-un drenaje urinario puede resolver o disminuir la dimensión de la fístula; si no mejora, debe someterse a procedimiento quirúrgico. (3) Hay varias técnicas y procedimientos para la reparación de este tipo de lesiones, la elección depende del tipo de fístula, las características del paciente y sus preferencias, así como la experiencia del cirujano.…”
Section: Antecedentesunclassified
“…Se ha notificado una incidencia mundial de la fístula urogenital iatrogénica de 0,1-4% 5 . Mientras las…”
Section: Introductionunclassified