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International Urogynecology Journal
Published in: International Urogynecology Journal 2/2008

01-02-2008 | Original Article

Urogenital fistulae: changing trends and personal experience of 46 cases

Author: Ismail K. El-Lamie

Published in: International Urogynecology Journal | Issue 2/2008

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Abstract

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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Metadata
Title
Urogenital fistulae: changing trends and personal experience of 46 cases
Author
Ismail K. El-Lamie
Publication date
01-02-2008
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 2/2008
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-007-0426-5

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