Limited Experience in Early Management of Genitourinary Tract Fistulas

Shelbaia, Ahmed; Hashish, Nawara M.

doi:10.1016/j.urology.2007.01.058

Cited by 14 publications

(4 citation statements)

References 7 publications

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“…For vesico-vaginal fistula, fistulectomy is the preferred management method. Delayed repair is the classic approach, but some articles advocated immediate repair because of better results ( 12 , 13 , 14 ) . Conservative management is also described, but an option not chosen frequently ( 15 ) .…”

Section: Discussionmentioning

confidence: 99%

Vesicocutaneus fistula after cesarean section-a curious complication: Case report and review

Tatar

Erdemoğlu

Soyupek

et al. 2016

tjod

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Vesicocutaneous fistulas are very rare pathologies in the urinary tract. We present the second case of a vesicocutaneus fistula after cesarean section, and discuss strategies for prevention, diagnosis, and treatment of this exceptional complication. A woman with a vesicocutaneous fistula after cesarean delivery was admitted and diagnostic tests including fluoroscopy, magnetic resonance imaging (MRI), and reconstructed MRI revealed the fistula tract and an urachal anomaly. The patient was treated through excision of the fistula tract. Laparotomy should be performed carefully, and the surgeon should be aware of the urachus. Inadvertent trauma to the urachus during laparotomy might cause serious unexpected complications. Possible etiologic factors for vesicocutaneous fistulae, prevention, and treatment methods are discussed.

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Section: Discussionmentioning

confidence: 99%

Vesicocutaneus fistula after cesarean section-a curious complication: Case report and review

Tatar

Erdemoğlu

Soyupek

et al. 2016

tjod

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“…La mancata riparazione intraoperatoria della lesione provoca la fuoriuscita di urina dalla via escretrice con sviluppo di una intensa reazione flogistica locale, erosione della limitrofa parete vaginale e successiva formazione di un tramite fistoloso. Gli interventi ginecologici più frequentemente complicati dall'insorgenza di una fistola ureterovaginale sono: l'isterectomia radicale eseguita per via addominale o per via transvaginale, o ancora interventi ricostruttivi della pelvi come ad esempio in caso di prolasso, interventi per incontinenza urinaria, parto cesareo, parto vaginale complicato da comparsa di emorragia, persistenza di pessari intravaginali o in rari casi per tecniche di fecondazione assistita (1, 9–12). Meno frequente è il riscontro di fistole dell'apparato genito-urinario come conseguenza di interventi vascolari o del colon (2).…”

Section: Risultatiunclassified

“…La legatura dell'arteria è la causa di molte delle lesioni accidentali che si riscontrano in letteratura e nella pratica clinica. La lesione iatrogena può essere legata a ureteri deviati rispetto al normale decorso a causa di proliferazioni limitrofe di natura maligna, o dislocati per compressione ab estrinseco , o per importante sowertimento della normale anatomia pelvica a causa di trattamenti di radioterapia che rendono ulteriormente fragili i tessuti irradiati (9, 13, 14). Risulta pertanto necessario approfondire lo studio preoperatorio dell'apparato urinario allo scopo di ridurre al minimo la possibilità di errori chirurgici.…”

Section: Risultatiunclassified

Ureterovaginal fistulae

Muzzonigro

Tombolini

2015

Urologia

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Ureterovaginal fistulae are pathological communications between the ureter and the vagina; it commonly occur as a rare but serious sequela of unrecognized distal ureteral injuries during pelvic operations. Patients may present symptoms as leakage of urine from the vagina, flank pain and fever; in some cases it could be possible also the loss of renal function. The purpose of this study is to review the articles from 1991 to 2014 to evaluate the most correct diagnostic procedures and endourological and surgical techniques used in the management of ureterovaginal fistula. Nowadays computered tomography and retrograde pielography are the most commonly diagnostic modalities used to identify fistulous tract and to describe its anatomical position. The major of ureterovaginal fistulae can be successfully managed by conservative methods. Modern endourological treatment will result in resolution of a ureterovaginal fistula if retrograde or anterograde passage of a suitable internal stent is feasible. When stenting failed or in complicated cases, ureteral reimplantation is necessary. Ureteroneocystostomy, psoas hitch and Boari flap are three different possible surgical techniques used to realized an ureteral reimplantation. Both open and mini invasive (laparoscopy and robot assisted) surgical approach have proved successful.

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“…However, the timing of ureteral reimplantation remains controversial [5, 6, 8]. The delayed fistula repair with a minimum of 3 months after primary surgery was preferred by some surgeons because the local tissue edema and ischemia in the short term after primary surgery might increase the risk of ureteral stricture.…”

Section: Introductionmentioning

confidence: 99%

Management for Ureterovaginal Fistula: A Retrospective Study Comparing Early and Delayed Ureteral Reimplantation

Long¹,

Ouyang²,

DaJun³

et al. 2022

Urol Int

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Introduction: The timing of surgical repair for ureterovaginal fistula (UVF) is under debate, here we introduce our experience to compare the safety and efficacy between early and delayed ureteral reimplantation for UVF. Methods: Between January 2012 and January 2020, 22 patients who were diagnosed with UVF had received ureteral reimplantation. Baseline characteristics, history of previous abdominal surgery, operative profile, and follow-up data were collected and analyzed. Results: Among 22 patients diagnosed with UVF, 12 patients received early ureteral reimplantation and others received delayed ureteral reimplantation. Both groups were comparable in baseline characteristics and detailed history of previous operations. The mean operative time of the early surgery group was 140.83 ± 35.28 min, while that of the delayed surgery group was 181.00 ± 43.83 min (p = 0.027). Patients of the early surgery group (183.33 ± 107.31 mL) had less blood loss compared with that of the delayed surgery group (285.00 ± 94.43 mL) (p = 0.030). After an overall mean follow-up of 34.55 months, the ureteral stricture rate of two groups was not statistically significantly different (16.67% in early repair vs. 40.00% in delayed repair, p = 0.348). Conclusion: With similar long-term outcomes, the early ureteral reimplantation had a shorter operative time and less blood loss. Moreover, the stress during the waiting period could be minimized. High-quality clinical studies with larger sample size are needed to confirm the superior nature of early surgery.

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Limited Experience in Early Management of Genitourinary Tract Fistulas

Cited by 14 publications

References 7 publications

Vesicocutaneus fistula after cesarean section-a curious complication: Case report and review

Vesicocutaneus fistula after cesarean section-a curious complication: Case report and review

Ureterovaginal fistulae

Management for Ureterovaginal Fistula: A Retrospective Study Comparing Early and Delayed Ureteral Reimplantation

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