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Ginecología y Obstetricia de México

Federación Mexicana de Ginecología y Obstetricia, A.C.
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2007, Number 01

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Ginecol Obstet Mex 2007; 75 (01)

Vesicovaginal fistula. Experience at Instituto Nacional de Perinatología

Roberto MP, Rodríguez CSE, Escobar BL, Ramírez IC
Full text How to cite this article

Language: Spanish
References: 9
Page: 31-34
PDF size: 160.74 Kb.


Key words:

fistula, diagnosis, treatment, healing.

ABSTRACT

Background: The damage of the lower urinary tract is originated by complications of obstetric or gynecological surgery, which if not detected timely determines the formation of fistulas.
Objective: To analyze the experience in diagnosing and treating vesicovaginal fistulas attended at the gynecologic urology clinic of the Instituto Nacional de Perinatología (INPer).
Material and method: Retrospective study of 27 files of patients diagnosed with vesicovaginal fistula at the gynecologic urology clinic of the INPer from January 1st 1992 trough December 31st 2005. The variables analyzed were age, parity, corporal mass index, surgical history, surgery performed to correct the fistula and postoperative evolution. Averages and standard deviation were calculated to describe data.
Results: Average age was 38.2 years. Abdominal hysterectomy (53.3%), followed by obstetric hysterectomy (33.3%), caused the most of complications. The most often used techniques to correct the fistula were Latzko operation, 19 patients (45.23%), and Sims’ fistulectomy, 11 patients (26.19%). The most used drainage was Foley probes, with 9.1 days average of use. Urinary tract infection was the most common complication (6.7%).
Conclusions. After our analysis, surgical treatment to patients with vesicovaginal fistula showed good results (71.4% of healing) with a minimum of complications (28.5% of recurrence).


REFERENCES

  1. Flores CO, Cabrera JR, Galeano PA and Torres FE. Fistulas of the urinary tract in gynecologic and obstetric surgery. Int Urogynecol J 2001;12:203-14.

  2. Lee RA, Symmonds RE, Williams TJ. Current status of genitourinary fistula. Obstet Gynecol 1988;72:313-66.

  3. Lawson J. Vaginal fistulas. Int J Gynecol Obstet 1993;40:13.

  4. Lower urinary tract operative injuries. ACOG Educational bulletin 1997;238:1-5.

  5. Stark G. A transvaginal repair of vesicovaginal fistulas. Obstet Gynecol 1990;35:36.

  6. Andersen TF, Loft A. Complications after hysterectomy. A Danish populations bases study 1978-1983. Acta Obstet Gynecol Scand 1993;72:570.

  7. Hochuli E, Benz J. Ureteral injuries in an obstetrics and gynecology training program. Obstet Gynecol 1988;72:82.

  8. Labasky RF. Prevention and management of urovaginal fistulas. Clin Obstet Gynecol 1990;33:382.

  9. Baltzer J. Early treatment of ureteral injuries found after gynecological surgery. J Urol 1977;118:25.




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Ginecol Obstet Mex. 2007;75