Original Paper

Our Experience with Genitourinary Fistulae
Abhay Kumar, Neeraj K. Goyal, Suren K. Das, Sameer Trivedi, Udai S. Dwivedi, Pratap B. Singh

Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

Address of Corresponding Author

Urol Int 2009;82:404-410 (DOI: 10.1159/000218528)

  Key Words

• Vesicovaginal fistula
• Ureterovaginal fistula
• Urethrovaginal fistula
• Youssef’s syndrome

  Abstract

Introduction: Our objective was to analyze the incidence, etiopathology, diagnosis and therapeutic aspects of the genitourinary fistula in an Indian population. Methods: This is a retrospective analysis of the genitourinary fistulae repaired at the Department of Urology, Institute of Medical Sciences, Banaras Hindu University, between January 1990 and December 2006. The surgical approach varied in each patient. Interposition grafts or flaps were used as and when required. The main outcomes analyzed were the incidence, etiology, surgical approaches, accessory procedure required, need for tissue interposition, cure rate per repair and overall success rate. Results: Out of 558 cases, 403 were vesicovaginal, 84 ureterovaginal, 43 urethrovaginal and 28 vesicouterine fistulae. The most common etiology was obstructed labor (72.2%), followed by hysterectomy. The transvaginal route was preferred for repair wherever possible. The transabdominal route was adopted for the repair of supratrigonal vesicovaginal, ureterovaginal and vesicouterine fistulae and if bladder augmentation was required. Conservative management was successful in 1.9% of the vesicovaginal fistulae and in 8 cases of ureterovaginal fistula. The remaining cases were managed surgically with excellent results. Conclusion: Genitourinary fistulae are not life-threatening but are socially debilitating. Surgical repair provides the definitive cure, but expectant treatment can be tried in selective patients.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Prof. P.B. Singh
Department of Urology, Institute of Medical Sciences
Banaras Hindu University
Varanasi 221005 (India)
Tel. +91 983 961 0185, Fax +91 542 231 3200, E-Mail pburology@gmail.com

  Article Information

Received: January 2, 2008
Accepted after revision: March 31, 2008
Published online: June 08, 2009
Number of Print Pages : 7
Number of Figures : 0, Number of Tables : 4, Number of References : 32