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Urovaginal fistula formation after gynaecological and obstetric surgical procedures: Clinical experiences in a Scandinavian series
- Source :
- Scandinavian Journal of Urology. 47:140-144
- Publication Year :
- 2012
- Publisher :
- Informa UK Limited, 2012.
-
Abstract
- The aim of this retrospective study was to review what kinds of surgical procedures are most frequently complicated by urovaginal fistulae, to find out how they were diagnosed and managed, and to study the outcome after surgical reconstruction.Nineteen women who underwent fistula repair at Sahlgrenska University Hospital between 2003 and 2009 were retrospectively studied by reviewing the medical records.For 17 of the 19 patients hysterectomy was the causative procedure. Fourteen patients developed vesicovaginal and five developed ureterovaginal fistula. Urethrocystoscopy was sufficient for the diagnosis in nearly 50% of the patients and when combined with methylene blue instillation 90% of all fistulae were found. Several patients sought medical advice due to vaginal leakage following gynaecological surgery without the doctor suspecting a fistula, and for these patients the diagnosis was delayed. Eighteen patients were operated on with an abdominal approach and one with a vaginal approach, in all cases a minimum of 3 months after primary surgery. The reconstruction technique included the interposition of vascularized tissue. None of the patients reported leakage or relapse at follow-up after fistula repair.Hysterectomy was the most common cause behind the formation of urovaginal fistulae. Misinterpretation of symptoms after gynaecological surgery was common even in cases where the symptoms were indicative of a urovaginal fistula. Delayed fistula repair after a minimum of 3 months, via the abdominal route and with the interposition of vascularized tissue, yielded an excellent final outcome.
- Subjects :
- Adult
medicine.medical_specialty
Urology
Fistula
medicine.medical_treatment
Obstetric Surgical Procedures
Risk Assessment
Vesicovaginal fistula
Young Adult
Gynecologic Surgical Procedures
Postoperative Complications
Risk Factors
Medical advice
medicine
Humans
Fistula repair
Retrospective Studies
Sweden
Hysterectomy
Vesicovaginal Fistula
business.industry
Incidence
Medical record
Retrospective cohort study
Middle Aged
medicine.disease
Gynaecological surgery
Surgery
Nephrology
Female
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 21681813 and 21681805
- Volume :
- 47
- Database :
- OpenAIRE
- Journal :
- Scandinavian Journal of Urology
- Accession number :
- edsair.doi.dedup.....65e62ec8dfa24dad654fc80a3a8adb53