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Results of treatment in 182 consecutive patients with genital fistulas.
- Source :
-
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 1995 Jan; Vol. 48 (1), pp. 43-7. - Publication Year :
- 1995
-
Abstract
- Objectives: To evaluate genital fistulas with the aim of improving strategies to prevent them.<br />Method: An institutional, retrospective, clinical analysis. One hundred eighty-two patients with genital fistulas managed consecutively between 1970 and 1993 were analyzed.<br />Results: About 60% of all fistulas were attributable to obstetric traumas whereas gynecologic surgery constituted only 24.7% of cases. The contribution of gynecologic surgery increased from 11.1% in 1970-75 to 60.6% in 1988-93. Approximately half of the patients had vesico-vaginal fistulas. Of the 45 patients with fistulas occurring following gynecologic surgery, 19 had undergone simple hysterectomy and eight had undergone radical hysterectomy. All cesarean sections had been performed after failed labor. Hysterectomy was performed due to myoma in nine patients, endometrial hyperplasia in two patients and pelvic relaxation in eight patients. As regards management of fistulas, the transvaginal approach was chosen in the vast majority of patients. The overall success rate after the primary repair of fistulas was 91.5% (162/177). Fifteen patients with failure of the primary repair were subjected to repeat repairs. The second repair was successful in 11 patients but the remaining four needed further repairs. The maximum was seven repairs to a recto-vaginal fistula before a satisfactory result could be achieved, which had initially occurred after a cesarean section.<br />Conclusion: Although the results of reparative surgery are promising, it would be more useful to encourage national measures to prevent in particular obstetric trauma.
- Subjects :
- Adult
Female
Humans
Postoperative Complications surgery
Puerperal Disorders surgery
Rectovaginal Fistula etiology
Reoperation
Treatment Outcome
Urethral Diseases etiology
Urinary Fistula etiology
Vesicovaginal Fistula etiology
Rectovaginal Fistula surgery
Urethral Diseases surgery
Urinary Fistula surgery
Vesicovaginal Fistula surgery
Subjects
Details
- Language :
- English
- ISSN :
- 0020-7292
- Volume :
- 48
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
- Publication Type :
- Academic Journal
- Accession number :
- 7698382
- Full Text :
- https://doi.org/10.1016/0020-7292(94)02269-0