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Inicio Actas Urológicas Españolas (English Edition) Treatment of urogenital fistula in women
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Vol. 36. Issue 3.
Pages 191-195 (March 2012)
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Vol. 36. Issue 3.
Pages 191-195 (March 2012)
Casuistry
Treatment of urogenital fistula in women
Tratamiento de la fístula urogenital en la mujer
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1349
C. Göktaş, R. Horuz
Corresponding author
rahimhoruz@yahoo.com

Corresponding author.
, G. Faydacı, A.C. Çetinel, O. Akça, S. Albayrak
Urology Clinics, Kartal Training and Research Hospital, Istanbul, Turkey
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Table 1. Patient and fistula characteristics, and operations performed.
Abstract
Introduction and objectives

We aimed to assess the results of the genitourinary fistula cases intervened in our center in a ten-year period.

Patients and methods

We evaluated the clinical data regarding genitourinary fistula from the medical records of 42 female patients who underwent surgery for this condition between May 2001 and June 2010. Age, previous medical history, diagnostic tools used, operative data and clinical outcomes of the patients were evaluated retrospectively.

Results

The mean age of patients was 51 years. Of 42 patients, 28 had vesicovaginal (VVF), 11 had ureterovaginal (UVF), and 3 had vesicouterine fistulas (VUF). Etiology of VVF was surgical trauma in 71.5% and obstetric trauma in 28.5% of the patients. O’Connor technique was performed as a single procedure in 12 VVF cases, and ureteroneocystostomy was added in 3. Transvesical repair was performed in 9, and transvaginal repair in 3 of the patients. All of 11 patients with UVF were of iatrogenic origin; ureteroneocystostomy was performed in 6, and Boari flap was performed in 5 of these patients. Three VUFs were repaired primarily. Success rates in VVF, UVF and VUF were 96, 100 and 100%, respectively.

Conclusion

In experienced hands and according with the related basic surgical principles, operative treatment in genitourinary fistula represents an effective modality with high success rate.

Keywords:
Genitourinary
Fistula
Surgical repair
Resumen
Introducción y objetivo

Nos hemos propuesto evaluar los resultados de los casos de fístula genitourinaria intervenidos en nuestro centro en un período de 10 años.

Material y métodos

Hemos evaluado la información clínica que respecta a la fístula genitourinaria a partir del historial médico de 42 pacientes femeninas, que se sometieron a cirugía por esta afección entre mayo de 2001 y junio de 2010. La edad, el historial médico, las herramientas de diagnóstico utilizadas, la información quirúrgica y los resultados clínicos de las pacientes fueron evaluados retrospectivamente.

Resultados

La media de edad de las pacientes fue de 51 años. De 42 pacientes 28 tenían fístula vesicovaginal, 11 ureterovaginal y tres vesicouterina. La etiología de la fístula vesicovaginal era traumatismo quirúrgico en el 71,5% y traumatismo obstétrico en el 28,5% de las pacientes. La técnica de O’Connor se llevó a cabo como único procedimiento en 12 casos de fístula vesicovaginal, añadiendo la ureteroneocistostomía en tres. La reparación transvesical se llevó a cabo en 9 y la reparación transvaginal en tres de las pacientes. Los 11 casos de fístula ureterovaginal eran de origen yatrogénico. La ureteroneocistostomía se llevó a cabo en 6 de estas pacientes y el flap de Boari en 5. Fundamentalmente se repararon tres fístulas vesicouterinas. El índice de éxito en las fístulas vesicovaginal, ureterovaginal y vesicouterinas fue del 96, 100 y 100% respectivamente.

Conclusión

En manos expertas, y de acuerdo con los principios básicos de cirugía, el tratamiento quirúrgico en la fístula genitourinaria representa una modalidad efectiva con un alto índice de éxito.

Palabras clave:
Genitourinario
Fístula
Reparación quirúrgica

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