Surgical Repair of Vesicovaginal Fistulae: A Ten-year Retrospective Study
| Autor: | Benni Nerstrøm, Torsten K. Pless, Niels C. Langkilde, Finn Lundbeck |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Reoperation
medicine.medical_specialty Urology medicine.medical_treatment Fistula Urinary Diversion Vesicovaginal fistula Surgical Flaps Recurrence medicine Humans Aged Retrospective Studies Surgical repair Urinary bladder Vesicovaginal Fistula business.industry Urinary diversion Retrospective cohort study medicine.disease Surgery Radiation therapy medicine.anatomical_structure Nephrology Vagina Female business |
| Zdroj: | Scandinavian Journal of Urology and Nephrology. 33:100-103 |
| ISSN: | 1651-2065 0036-5599 |
| Popis: | Vesicovaginal fistulae in the western world generally occur as complications to pelvic surgery or radiation therapy of pelvic cancers. We have reviewed our results of vesicovaginal fistula closure procedures over a 10-year period.From 1985 to 1996, 55 patients were referred to our department due to vesicovaginal fistulae. Five patients had fistulae due to malignant recurrence and one patient was considered inoperable. Thus, 49 patients were operated on. Thirty patients had fistulae resulting from pelvic surgery. Nineteen of the 25 patients admitted with fistulae secondary to radiation therapy of pelvic cancers were operated on.Of the 30 patients with postoperative fistulae, 23 had an abdominal repair and 7 a vaginal repair. A success rate of 90% was achieved after a first closure procedure, as 3 patients within a month experienced a recurrence. These three recurrences were all successfully closed in a second operation, augmenting the success rate to 100% in this group of patients. In the group of patients with fistulae caused by irradiation, a urinary diversion was performed in 12 patients, and in 7 patients a primary attempt to close the fistula was made, either by an abdominal approach (2 patients) or by a vaginal approach (5 patients). The fistula recurred in 6 of these 7 patients. Despite several additional attempts to close the recurrent fistulae, only one patient was successfully operated on.It seems that vesicovaginal fistulae resulting from pelvic surgery, in our hands, can be managed successfully either by an abdominal or vaginal approach. For patients with vesicovaginal fistulae resulting from radiation therapy, a urinary diversion appears to be the method of choice. |
| Databáze: | OpenAIRE |
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