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[Complex vesicovaginal fistula. Report of 55 cases]
K Tazi1, J el Fassi, T Karmouni
1Service d'urologie B, hôpital Avicenne, Rabat, Maroc. tazikarim@yahoo.com
Objective:
To specify the clinical and therapeutic peculiarities of complex vesico-vaginal fistulas.
Material And Methods:
55 cases of complex vesico-vaginal fistulas are reported. After the clinical diagnostic all the patients had an intravenous excretory urogram. The fistulas were classified according to the Benchekroun classification.
Results:
The mean age was 34 years (17-70 years). The diagnostic was made clinically in all the patients. Thirteen patients had an abnormal intravenous excretory urogram. The treatment was made by a vaginal way in 45 patients, by an abdominal way in three patients and by a mixed way in two patients. Four patients had an urinary diversion and one refused the treatment. Among the 50 patients whose fistula was treated, 44 (88%) were continent whom 26 (52%) after one operation, 15 (30%) after two operations and three (6%) after three operations.
Conclusion:
The complex vesico-vaginal fistulas as all the vesico-vaginal fistulas are diagnosed clinically. The intravenous excretory urogram is indispensable to search an associated ureteral lesion. The treatment is surgical and usually needs the interposition of a vascularised graft.