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Complex obstetric fistulae--two case reports.

J Ashmore1, F Attapattu

  • 1Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of the West Indies, Queen Elizabeth Hospital, Barbados, West Indies.

The Ceylon Medical Journal
|October 29, 2000
PubMed
Summary
This summary is machine-generated.

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Complex obstetric fistulae, including vesico-urethro-rectovaginal and vesico-cervico-vaginal types, were successfully repaired. Surgical techniques varied, with one patient achieving continence after multiple attempts, highlighting the challenges in managing these severe injuries.

Area of Science:

  • Obstetrics and Gynecology
  • Urology
  • Surgical Repair

Background:

  • Complex obstetric fistulae are severe injuries resulting from prolonged or obstructed labor.
  • Mismanagement of labor can lead to devastating conditions like vesico-urethro-rectovaginal and vesico-cervico-vaginal fistulae.

Observation:

  • Two cases of complex obstetric fistulae are presented.
  • Case 1 involved a vesico-urethro-rectovaginal fistula in a young patient, requiring multiple surgical interventions.
  • Case 2 involved a vesico-cervico-vaginal fistula successfully repaired via a transvaginal route.

Findings:

  • A modified Martius graft was employed in Case 1.
  • Ureteral transplantation was avoided due to the patient's young age.
  • Seventeen repair attempts over ten years ultimately led to vesical and rectal continence in Case 1.

Related Experiment Videos

  • Successful first-attempt transvaginal repair was achieved in Case 2.

    • Implications:

    • Complex obstetric fistulae require tailored surgical approaches.
    • Persistent and challenging cases may necessitate multiple interventions.
    • Minimally invasive techniques, like transvaginal repair, can be highly effective.
    • Successful repair restores quality of life and continence, crucial for patient well-being.