Fístulas vesicouterinas. nuestra experiencia tras 25 años

OBJECTIVE To determine the current state of vesicouterine fistulae in our hospital, the factors associated with their development and the findings obtained from the treatments used. MATERIAL AND METHODS We carry out a retrospective study on a group of patients suffering from vesicouterine fistulae who were treated in our service for the last 25 years with a 2 year minimum follow-up. RESULTS 6 cases of vesicouterine fistulae were evaluated. In 83.3% (5/6) of the cases occurred following caesarean section. The average age of the patients was 36.5 years old. In 50% of the cases, urinary incontinence immediately after surgery determined an early diagnosis. In 5 patients deferred abdominal surgical approach was carried out. All of the patients remained asymptomatic during the follow-up years. Two pregnancies were recorded 24 months after repair with a full term delivery. CONCLUSIONS The vesicouterine fistula, despite being infrequent, is no longer an exceptional diagnosis. Currently, the low segmentarian caesareans constitute the major isolated risk factor for fistula development. We recommend a deferred surgical repair without discarding a conservative approach for those cases of small and early fistula.