Evaluationof Methodsof Treatment of Urinary Fistulae Inwomen

Foda, M. Sadek

doi:10.1111/j.1471-0528.1959.tb02045.x

Cited by 9 publications

(2 citation statements)

References 6 publications

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“…This contrasts earlier reports where the classical obstetric fistula constituted 85-90% of cases of urogenital fistulae [1,[61][62][63]. This changing trend has been observed since the 1950s [63]. On the other hand, the occurrence of iatrogenic fistulae has gone up due to inexperience and lack of training as witnessed in cases after instrumental delivery (two cases in the current small series) and iatrogenic uterine rupture (eight cases).…”

Section: Discussioncontrasting

confidence: 54%

“…Similarly, a recent series from the Urology and Nephrology Center in Mansoura, Egypt, covering a period of 18 years (1985-2003) and analyzing 120 patients with urological injuries after gynecologic and obstetric surgery, reported that neglected obstructed labor was a major cause of vesicovaginal fistula before 1990 [87.5% of cases (21 of 24)], while the incidence decreased remarkably in the last decade due to better patient health education and primary health care [60]. This contrasts earlier reports where the classical obstetric fistula constituted 85-90% of cases of urogenital fistulae [1,[61][62][63]. This changing trend has been observed since the 1950s [63].…”

Section: Discussioncontrasting

confidence: 52%

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Urogenital fistulae: changing trends and personal experience of 46 cases

El-Lamie

2007

Int Urogynecol J

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A retrospective study of 46 patients with different types of urogenital fistulae treated by the author during the period from January 1997 to December 2006 is presented. Twenty-two (48%) cases had a vesicovaginal fistula of which 16 (73%) were repaired vaginally and 6 (27%) were repaired abdominally. The remaining fistulae were as follows: 14 (30%) unilateral ureterovaginal fistulae, 6 (13%) ureterovesicovaginal fistulae (one bilateral), and 4 (9%) vesicouterine fistulae. All were repaired abdominally except for one patient with ureterovesicovaginal fistula needing continent urinary diversion using Mainz type II pouch. All fistulae were iatrogenic except one case (2%) which was due to neglected obstructed labor. The iatrogenic causes were gynecologically related in 26 (57%) patients and obstetrically related in 19 (41%) cases. There were two (9%) failed repairs in the vesicovaginal cases, one in each group, and both were salvaged by a secondary surgery. In view of this selected retrospective study and in association with other reports, it seems that with the improvement in the basic health-care services in Egypt, there is a change in the etiology of urogenital fistulae with the vast majority being physician related and no more related to neglected obstructed labor. Such shortcoming should be addressed in the current gynecological surgery training and residency programs.

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