Vesicovaginal and Ureterovaginal Fistulas: A Summary of 25 Years of Experience

Goodwin, Willard E.; Scardino, Peter T.

doi:10.1016/s0022-5347(17)55941-8

Cited by 263 publications

(122 citation statements)

References 9 publications

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“…A double J catheter was placed near the mouth of the fistula in trigonal fistulas. Four patients with a fistula size greater than 10 mm and supratrigonal Mean size of the fistulas (mm) 15 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) were repaired abdominally and an omental flap interposition was made. The other four patients with a fistula size less than 10 mm and supratrigonal were repaired abdominally and a layered closure was made without omental flap interposition ( Table 3).…”

Section: Resultsmentioning

confidence: 99%

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Experience of our surgery in iatrogenic vesicovaginal fistulas

Karateke¹,

Asoğlu²,

Selçuk³

et al. 2010

J Turkish German Gynecol Assoc

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Objective: In this study, transvesical and transvaginal approaches used in our clinic for the treatment of gynecologic iatrogenic vesicovaginal fistulas are discussed. Material and Methods: 11 patients with vesicovaginal fistula admit-ted to the Department of Urogynecology, Zeynep Kamil TeachingResearch Hospital between 2005-2009 were enrolled in our study. Transvesical and transvaginal fistula repair were performed on all patients. All patients were treated by surgical repair, 4 cases by a classic transabdominal approach, 5 cases by an omental flap interposition and 2 cases by a martius flap interposition. Results:The most common cause of iatrogenic vesicovaginal fistula in our patients was total abdominal hysterectomy for benign conditions (n=10/11). The mean patient age was 43 years (34-53) and the mean time from the causative surgery to the operation was 7.5 months (3-12). The surgical techniques were successful in all patients. There were no intraoperative complications and no postoperative recurrences. Conclusion:The mouth of the fistula should be determined clearly on preoperative evaluation and surgery procedure should be planned according to the fistula aperture. The point to be careful of is excision of all diseased tissue in the bladder and vagina, complete separation of the bladder from the vagina with a margin of healthy tissue, and watertight closure of both bladder and vagina without tension. The aim of the vascularized tissue interposition between the closed bladder and the vagina is to provide the improvement of vascularity. We believe that in the treatment of supratrigonal and large fistulas, the transvesical approach with use of omental flap interposition is more effective, while, in the treatment of small and trigonal fistula,the transvaginal approach with use of martius flap interposition is an effective tecnique. Abstract ÖzetOriginal Investigation 137

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Section: Resultsmentioning

confidence: 99%

“…Hysterectomy, both by transabdominal and transvaginal approaches, is the most common procedure, comprising 75% of fistulae (16). The overall incidence varies between 0.5 and 1.5%, and bladder injuries are more common than ureteric ones (1, 2).…”

Section: Discussionmentioning

confidence: 99%

Experience of our surgery in iatrogenic vesicovaginal fistulas

Karateke¹,

Asoğlu²,

Selçuk³

et al. 2010

J Turkish German Gynecol Assoc

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“…An estimated 2-3 million women globally and majorly in sub-Saharan Africa and Asia, suffer from fistula with an annual incidence of 50,000-100,000 women (Wall et al,2005& Tuncalp et al,2015.Obstetric Fistula (OF) is a medical condition that involves an opening or perforation between the vagina and the bladder or the vagina and the rectum. Though global in its prevalence it is very rare in the developed world and its cause is mainly from malignant diseases, radiation therapy, or surgical malfunctions during delivery (Goodwin & Scardino, 1980, Langkilde et al,1999.…”

Section: Introductionmentioning

confidence: 99%

Determinants and Heterogeneity of Time -to- Recovery from Obstetric Fistula Patients; Comparison of Acceleration Failure Time and Parametric Shared Frailty Models.

Demissie¹

2017

IJSP

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Obstetric Fistula is a medical condition that involves an opening or perforation between the vagina and the bladder or the vagina and the rectum. It is a serious, life threatening and often debilitating medical condition that affects thousands of women in developing countries.The study consists of 270 obstetric fistula patients having all required information who were taking treatment at Jimma University Specialized Hospital in south west Ethiopia from January, 2011 to January ,2017. The log-rank and generalized wilcoxon test were used to explore the association between the recovery time and different independent categorical covariates. Then using different baseline distribution parametric models were employed to have an appropriate model for the recovery time/status of the patients based on Akaike information criteria (AIC) of the model. Result of Both log-rank and generalized wilcoxon test showed that there were significant differences among obstetric fistula patients in survival experience of weight , marital status, Residence, Incontinence, Antenatal care, mode of delivery, status of urethra and types of fistula of patients at 5% level of significance. Based on AIC log-normal gamma shared frailty model is an appropriate model and there is heterogeneity between patients with zone. The final model showed that marital status, Residence, Incontinence, Antenatal care, status of urethra and types of fistula were the determinants of recovery status of the patients at 5% level of significance. In Conclusion, the result showed that married women, rural residence, incontinence of urine more than 3 months, hadn't antenatal care and completely damaged urethra were prolonged time recovery time of patients whereas having recto-vaginal-fistula shorten recovery status than vesico-vaginal fistula group of patients.

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“…The vaginal approach seems to be easy, safe, and quicker for most early simple fistulas, 16 while the abdominal approach may be indicated to address supratrigonal VVFs 17 or more complex fistulas, such as those that result from radiation therapy with small capacity bladders. 18 Although the surgical results are mainly related to the cause of the fistula and the experience of the surgeon, failure rates range from 4% to 37%, according to the surgical approach: open abdominal or vaginal techniques.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Management of Iatrogenic Lesions

Abreu

Tanaka²,

Abreu³

et al. 2008

Journal of Endourology

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Purpose: To present our series of patients who underwent laparoscopic correction of iatrogenic lesions and a review of the literature. Patients and Methods:We evaluated 23 patients who underwent laparoscopic correction of iatrogenic lesions.Thirteen patients had open surgery, 6 had an endoscopic procedure, and 4 had a laparoscopic approach as the first surgical procedure. Vesicovaginal fistulas (VVF) developed in seven patients after open abdominal hysterectomies, and 1 patient presented with a VVF after ureterolithotripsy. A urethral cutaneous fistula developed in one patient after a laparoscopic resection of endometriosis nodules, and 1 patient presented with a ureterovaginal fistula after a perineoplasty. Three patients presented with encrusted ureteral stents after ureterolithotripsy. Ureteral stenosis developed in seven patients: three after open abdominal surgery, three after ureteroscopy, and one after pyeloplasty. One patient had a ureteral injury during laparoscopic partial nephrectomy, and two patients had bowel injuries after a tension-free vaginal tape procedure and a laparoscopic radical prostatectomy. Results: All patients underwent laparoscopic correction of the iatrogenic injuries. One patient had an early recurrence of a VVF, and one patient had a recurrence of a ureteral stenosis. There was one conversion to open surgery because of technical difficulties and one major bleeding event that necessitated blood transfusion. A lower limb compartmental syndrome developed in one patient. Conclusion: Despite the small number of patients and different types of surgeries performed, laparoscopic management of iatrogenic lesions seems to be feasible and safe in experienced hands. Its precise role in the management of this stressful condition still needs to be determined. 1279

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Vesicovaginal and Ureterovaginal Fistulas: A Summary of 25 Years of Experience

Cited by 263 publications

References 9 publications

Experience of our surgery in iatrogenic vesicovaginal fistulas

Experience of our surgery in iatrogenic vesicovaginal fistulas

Determinants and Heterogeneity of Time -to- Recovery from Obstetric Fistula Patients; Comparison of Acceleration Failure Time and Parametric Shared Frailty Models.

Laparoscopic Management of Iatrogenic Lesions

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