2006, Number 3
Experiencia del servicio de Urología del Hospital Juárez de México en el manejo de la fístula vesicovaginal
Díaz EMC, Viveros CC, Lugo GJA, Moreno RR, Cruz TJ
Full text
Language: Spanish
References: 7
Page: 109-115
PDF size: 233.22 Kb.
ABSTRACT
Background. Vesicovaginal fistulae represents a mayor problem that affects the lifestyle of women who is involved, altering the biologic, psychological and social areas.Method. We reviewed the expedients of patients at the Hospital Juárez de México with diagnostic of vesicovaginal fistulae in the period from January 1990 to July 2005, considering age, etiology, associated factors and used therapy.
Results. Fifty-one patients were recognized with mean age of 49.8 years, and mean evolution time to surgical management of 14.90 months. Etiology: obstetric: 13.7 %; gynecological: 76.5 % and oncological: 9.80 %. We followed protocol with hematic biometry, glucose, urea, creatinine, general urine analysis, urine culture, cystogram, cystoscophy, kidney sonication and intravenous pyelogram. Localization: supratrigonal: 82.35 %, infratrigonal: 15.68 % and transtrigonal: 1.96 %. Surgical repair was made in 100 % of cases: abdominal approach: 84.31 % and vaginal: 15.68%. Success rate was 88.24 %; reintervention was re- 1 Residente de Urología. Hospital Juárez de México. 2 Jefe de quired in 11.76 % with there was 1 death.
Conclusions. The main etiology was gynecological, followed by obstetric and oncological causes, with surgical repair at our medical center gynecological, preferring surgical approach rather than vaginal, getting better results than those reported in the literature. The individualization of therapy will allow more effectiveness in the reconstruction of fistulae and less recurrence.
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