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[Urinary fistula after radical hysterectomy with lymph node excision].
H D Methfessel1, U Retzke, G Methfessel
1Universitäts-Frauenklinik Halle.
Geburtshilfe Und Frauenheilkunde
|February 1, 1992
Summary
Urogenital fistulas occurred in 1.43% of radical hysterectomies. Surgical interventions like ureterocystoneostomy and Latzko
Area of Science:
- Gynecologic Oncology
- Urology
- Surgical Complications
Context:
- Radical hysterectomy for cervical cancer involves significant surgical dissection.
- Urogenital fistulas are a known, though infrequent, complication of these procedures.
Purpose:
- To analyze the incidence, management, and outcomes of urogenital fistulas following radical hysterectomy.
- To evaluate surgical techniques for fistula repair and their long-term efficacy.
Summary:
- A study of 908 radical hysterectomies revealed 13 cases (1.43%) of urogenital fistulas (12 uretero-vaginal, 1 vesico-vaginal).
- Management included conservative measures (percutaneous nephrostomy, spontaneous resolution), ureterocystoneostomy (Boari, psoas fixation), and Latzko's procedure.
- Surgical repairs demonstrated successful outcomes with normal urography at 1-year follow-up.
Impact:
- Effective surgical strategies can achieve successful fistula repair with good long-term outcomes.
- Increased vigilance and potentially modified surgical approaches may be needed for advanced cervical cancer stages (T2b).