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2016, Number 1

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RCU 2016; 5 (1)

Vesico vaginal fistulae as a complication of gynecobstetric surgery

López TU, Milián ER, Caravia BF, Caravia PI, Collazo AS

Language: Spanish
References: 34
Page:
PDF size: 280.29 Kb.


ABSTRACT

Introduction: Vesicovaginal fistulae (VVF) are one of the most frequent complications of obstetrics and gynecological surgery, although in developed countries the gyncecological causes have more incidence than the obstetric ones.
Materials and Methods: An observational, retrospective, cross-sectional study was conducted in 45 patients diagnosed with urinary fistulas from January 2003 to December 2013 with the aim of characterizing the patients with complications of gynecobstetric surgery of these, 30 (66,6%) were VVF, constituting the sample. The variables studied were age, hospital stay, ginecobstetric cause of VVF, location and number of fistulous orifices in the bladder, urological surgical technique used and outcome of it pointing the results in absolute numbers and percentage. The results are presented in tables and graphs.
Results: Most patients had an average age of 38 years old and the average hospital stay was 11.4 days. The most common gynecological cause was uterine myoma and hysterectomy, the surgical procedure used. The most common were the unique postrigonales VVF, smaller than 3 cm. The urologic surgical technique used was Trendelemburg and the percentage of success was high and only two patients required reoperation. Urinary infection and surgical wound complications were the complications observed.
Conclusions: Good results were obtained with the surgical treatment of VVF but similar studies should be conducted in each working group to evaluate the outcomes of the techniques used.


REFERENCES

  1. 1.- Obarisiagbon EO,Olagbuji BN,Onuora VC,Oguike TC, Ande AB.Iatrogenic urological injuries complicating obstetric and gynaecological procedures. Singapore Med J.2011 Oct; 52(10):738-41.

  2. - Lee JS, Choe JH, Lee HS, Seo JT. Urologic Complications Following Obstetric and Gynecologic Surgery. Korean J Urol 2012; 53:795-799

  3. 3.- Ozdemir E, Ozturk U, Celen S, Sucak A, Gunel M, Guney G, et al. Urinary complications of gynecologic surgery: iatrogenic urinary tract system injuries in obstetrics and gynecology operations. Clin Exp Obstet Gynecol 2011; 38:217-20.

  4. - Vasavada SP, Rackley R, GrassoIII M. Vesicovaginal and ureterovaginal fistula. 2011. [actualizado 14 septiembre 2011; citado 13 abril 2012] Disponible en: http://emedicine.medscape.com/article/452934-overview.

  5. - Blaivas JG, Mekel G. Management of urinary fistulas due to midurethral sling surgery. J Urol.2014 Oct;192(4):1137-42. Disponible en : http://www.ncbi.nlm.nih.gov/pubmed/24742595

  6. 6-. Feddock J ,Randall M ,Kudrimoti M ,Baldwin L ,Shah P ,Weiss H , Desimone C . Impact of post-radiation biopsies on development of fistulae in patients with cervical cancer. Gynecol Oncol.2014 May; 133(2):263-7. http://www.ncbi.nlm.nih.gov/pubmed/24525114

  7. 7.-Leos-Acosta C, Morales-Montor J, Vázquez-Ortega L, Castellano-Orozco M, Camarena-Reynoso H, Shuck-Bello C, et al. Resección de fístula vésicovaginal por vía laparoscópica, con abordaje extravesical. Rev Mex Urol 2009; 69(4):185-189.

  8. Dolan LM, Easwaran SP, Hilton P. Congenital vesicovaginal fistula in association with hypoplastic kidney and uterus didelphys. Urology. 2004; 63:175-7.

  9. 9.-Puri M, Goyal U, Jain S, Pasrija S. A rare case of vesicovaginal fistula following illegal abortion. Indian J Med Sci. 2005; 59:30-1.

  10. 10.- WHO. 10 facts on obstetric fistula. Revisado en diciembre 2015. Disponible en http://www.who.int/features/factfiles/obstetric_fistula/en/

  11. 11.-Göktaş C, Horuz R, Faydacı G, Çetinel AC, Akça O, Albayrak S. Tratamiento de la fístula urogenital en la mujer Actas Urol Esp. 2012; 36(3):191-5.

  12. 12.- Harrison MS, Mabeya H, Goldenberg RL, McClure EM. Urogenital fistula reviewed: a marker of severe maternal morbidity and an indicator of the quality of maternal healthcare delivery. Maternal Health, Neonatology and Perinatology 2015. Disponible en : http://mhnpjournal.biomedcentral.com/articles/10.1186/s40748-015-0020-7

  13. 13.-Kerkebe M, Bley E, Pizzi P, Falcón C, Iturriaga C. Candia W, et al. Reparación Laparoscópica de Fístula Vésicovaginal mediante técnica retrovesical: Una serie de 6 pacientes Rev Chil Obstet Ginecol 2009; 74(1): 30-35,

  14. - Corn J. Lessons from the developing world: Obstructed labor and the vésico-vaginal fistula. Med Gen Med 2003; 5(3):24.

  15. 15.- Bouya PA,Odzébé AW,Otiobanda FG,Itoua C,Mahoungou-Guimbi K,Banga MR,Andzin M,Ondongo-Atipo M,Ondzel S, Avala P. Urological complications of gynecologic surgery. Prog Urol. 2011 Nov; 21(12):875-8. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/22035914

  16. 16-. Adler AJ, Ronsmans C,Calvert C and Filippi V. Estimating the prevalence of obstetric fistula: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2013; 13: 246. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3937166/

  17. 17.- Cowgill KD, Bishop J†, Norgaard AK†, Rubens CE, Gravett MG. Obstetric fistula in low-resource countries: an under-valued and under-studied problem - systematic review of its incidence, prevalence, and association with stillbirth. BMC Pregnancy and Childbirth, 2015, vol15:193. Disponibleen : http://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-015-0592-2

  18. - Petros P, Williams G, Browning A. Post vesico-vaginal fistula repair incontinence-A new hypothesis and classification potentially guide prevention and cure. PELVIPERINEOLOGY, 2015, p. 48.

  19. - Zinman L, Libertino JA. Techniques in the management of the recurrent vesico vaginal fistula. Surg Clin North Amer.2006; 53: 479.

  20. 20-. Priyadarshi V,Sinhamahapatra R,Kundu AK, Pal D. Development of VVF following double J stent placement. BMJ Case Rep. 2014 May 9 .Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/24813199

  21. 21.- Ruiz Reyes RE, Falcón Fraga C. Fístula vesicovaginal. Nuestra experiencia. Rev Méd electrón [Seriada en línea] 2007; 29(6). Disponible en: URL: http://www.cpimtz.sld.cu/revistamedica/ano%202007/vol6%202007/%20tema03.htm [consulta: 27 Octubre 2012]

  22. 22.- Roa Saavedra X, Guzman Chaves F. Lesiones ureterales iatrogénicas. Revisión de una serie de casos en el Hospital Militar Central. Urol. Colomb. 2009; 18(2): 75-80

  23. 23.- Tsivian M Jr,Tsivian M,Sidi AA, Tsivian A. Uretero-vesico-cervical fistula following a caesareansection: a unique case report. Int Urogynecol J. 2012 Nov; 23(11):1639-41. Disponible en : http://www.ncbi.nlm.nih.gov/pubmed/22527547

  24. 24.- Shaker H,Saafan A,Yassin M,Idrissa A, Mourad MS Obstetric vesico-vaginal fistula repair: should we trim the fistula edges? A randomized prospective study. NeurourolUrodyn.2011 Mar; 30(3):302-5. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/21308748

  25. 25.-Reisenauer C. Vesicovaginal fistulas: a gynecological experience in 41 cases at a German pelvic floor center. Arch Gynecol Obstet. 2015 Aug; 292(2):245-53. Disponible en : http://www.ncbi.nlm.nih.gov/pubmed/26001626

  26. 26.- Montoya Martínez G, Ledesma Rodríguez AG, Serrano Brambila E, Moreno Palacios J. Fístula vesicovaginal: abordaje abierto abdominal versus laparoscópico. GinecolObstet Mex 2013; 81:587-592

  27. 27.- Razi A,Mazloomfard MM,Ajami H, Moeini A. Combined vagino-abdominal approach for management of vesicovaginal fistulas: a 10 years' experience. Arch Gynecol Obstet. 2015 Jul; 292(1):121- 5. Disponible en : http://www.ncbi.nlm.nih.gov/pubmed/25534159

  28. 28.- Liedl B,Khoder WY,Ruhdorfer-Metz B,Stief CG, Waidelich R. Outcomes of a bladder preservation technique in female patients undergoing pelvic exenteration surgery for advanced gynaecological tumours. Int Urogynecol J. 2014 Jul; 25(7):953-60. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/24633066

  29. 29.- Vaso M,Betschart C,Egger H,Fink D, Schmidt AM. Surgical technique of a recurrent post-radiation vesicovaginal fistula with a small intestine graft. Arch Gynecol Obstet. 2015 Sep; 292(3):485-8. Disponible en : http://www.ncbi.nlm.nih.gov/pubmed/25986894

  30. 30.- Endo Y,Iigaya S,Nishimura T,Ishii N,Kitaoka Y,Kawashima T,Ohara C,Hamasaki T, Kondo Y. A case of vesicovaginal fistula repair with rectus abdominus myofascial interposition flap after radical hysterectomy and radiation therapy. Hinyokika Kiyo.2014 Oct; 60(10):497-9. Disponible en : http://www.ncbi.nlm.nih.gov/pubmed/25391781

  31. 31.-Miklos JR,Moore RD, Chinthakanan O Laparoscopic and Robotic-assisted Vesico vaginal Fistula Repair: A Systematic Review of the Literature. J Minim Invasive Gynecol. 2015 Jul-Aug; 22(5):727-36. Disponible en : http://www.ncbi.nlm.nih.gov/pubmed/25764976

  32. 32.-GarcíaSeguí, R. Laparoscopic repair of vesico-vaginal fistula without intentional cystotomy and guided by vaginal transillumination.Actas Urol Esp. 2012 Apr; 36(4):252-8. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/22188749

  33. 33.- Mohr S,Brandner S,Mueller MD,Dreher EF, Kuhn A.Sexual function after vaginal and abdominal fistula repair. Am J Obstet Gynecol.2014 Jul; 211(1):74. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/24530974

  34. 34.- Osorio-Acosta VA. Fístulas urinarias. Editorial Ciencias Médicas, La Habana. 2006.




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