Female Urinary Tract Fistulas

Gerber, Glenn S.; Schoenberg, Harry W.

doi:10.1016/s0022-5347(17)36045-7

Cited by 107 publications

(43 citation statements)

References 67 publications

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“…In another series, four patients who developed a fistula after abdominal and vaginal hysterectomy were treated with bladder drainage for periods of 19-54 days; all remained dry after the removal of the catheter [14]. It has been suggested that if healing has not occurred within 4 weeks, it is unlikely that a fistula will close spontaneously [15].…”

Section: Discussionmentioning

confidence: 99%

Vesicovaginal fistulas: a gynecological experience in 41 cases at a German pelvic floor center

Reisenauer

2015

Arch Gynecol Obstet

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Section: Discussionmentioning

confidence: 99%

Vesicovaginal fistulas: a gynecological experience in 41 cases at a German pelvic floor center

Reisenauer

2015

Arch Gynecol Obstet

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“…Vesicovaginal fistulas are the most common fistula in the urinary system [3], and their etiology varies in different nations. In developed countries, at least 75% of vesicovaginal fistulas are caused by pelvic operations of gynecology, urology, and others, with obstetric operations making up most of the operational causes.…”

Section: Discussionmentioning

confidence: 99%

Vesicovaginal Fistula Repair Using a Transurethral Pointed Electrode

et al. 2010

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The most common cause of vesicovaginal fistulasis injury to the bladder at the time of surgery. The operation most frequently responsible for vesicovaginal fistula formation is hysterectomy. The first successful transvaginal approach to vesicovaginal fistula repair was reported by Sims in 1838. Although many surgical procedures exist, there is no best approach for all patients with vesicovaginal fistula. However, it is an essential surgical principle that the fistulous tract and scar should be excised completely. Here we report our technique using a transurethral pointed electrode for the treatment of multiple, small vesicovaginal fistulas and its outcome. The most common cause of vesicovaginal fistulas is surgery, and complications by obstetric operations including hysterectomy constitute around 90%. Vesicovaginal fistulas are observed in 0.5% of hysterectomy cases [1].Since Sims [2] in the United States succeeded in operating through the vagina in 1852, discussion on surgical techniques and the operative period for the treatment of vesicovaginal fistulas has continued. However, all fistula surgeries should be conducted under the basic principle that the fistula and scar will be completely excised. The success rate of treatment of a simple vesicovaginal fistula is reported to be 75% to 97%, but that of combined vesicovaginal fistulas is reported to be lower in cases of recurrence, with the existence of tumor, or with a history of radiation treatment.The purpose of this case study was to report a case in which a vesicovaginal fistula after hysterectomy was treated by using a transurethral pointed electrode. CaseThe patient, a 46-year-old female, visited our hospital with postoperative, consistent urinary incontinence. Her medical history included a laparoscopic hysterectomy due to uterine myoma three months before her current visit. Because injury to the urinary bladder was found immediately postoperatively, she had twice undergone restoration of the bladder through the vagina and the abdomen and had an artificial ureter in place for three months as the result of partial injury in the right ureter. The results of blood tests at the time of her current visit showed that her vital signs were within the normal range, her hemoglobin was 13.0 g/dL, and her serum creatinine was 0.80 mg/dL. High magnification of urinalysis exhibited a number of both erythrocytes and leukocytes, and Escherichia coli was cultured in the urine culture test. No abnormal findings were observed in the right ureter in urography after re-

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“…It seems that to be successful the catheter treatment should last up to 2 months. However, in some recent reports early closure has been suggested [13,14]. Probably this is reasonable when considering how troublesome continuous urinary leakage is for the patient.…”

Section: Discussionmentioning

confidence: 99%

Urological injuries in conjunction with gynecologic surgery-10 years' experience

et al. 1995

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Abstract:A 10-year evaluation (1983)(1984)(1985)(1986)(1987)(1988)(1989)(1990)(1991)(1992)) of 23 patients (mean age 49 years) with urologic injuries in conjunction with gynecologic surgery is presented. There were nine vesicovaginal fistulas, eight ureteral injuries, three bladder lesions, two posterior urethrovaginal fistulas and one vesicocervical fistula. The total incidence of urologic injuries from all major gynecologic operations (n = 16400) was 0.09% and that of abdominal hysterectomies (n = 4082) 0.17%. Vesicovaginal fistulas and ureteral injuries comprised two-thirds (17/23) of all injuries. All vesicovaginal fistulas followed abdominal hysterectomy, whereas almost half (3/8) of ureteral injuries were recognized after radical hysterectomy. Of nine vesicovaginal fistulas two were cured by prolonged transurethral catheter drainage: the other seven underwent successful transabdominal repair at first attempt. All the eight ureteral injuries were cured successfully at the first attempt, five of them by ureteroneocystostomy and the others with ureteral stent placement. One of the urethrovaginal fistulas was repaired successfully at the first attempt, the other required a second repair. At follow-up (mean 4 years) all patients were doing well. Urologic injuries after gynecologic surgery are extremely rare (0.09% in our series) but when they occur they can be consistently repaired by modern surgical techniques.

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Female Urinary Tract Fistulas

Cited by 107 publications

References 67 publications

Vesicovaginal fistulas: a gynecological experience in 41 cases at a German pelvic floor center

Vesicovaginal fistulas: a gynecological experience in 41 cases at a German pelvic floor center

Vesicovaginal Fistula Repair Using a Transurethral Pointed Electrode

Urological injuries in conjunction with gynecologic surgery-10 years' experience

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